The Philippines is on course to become an “ageing society” by 2030, with adults aged 60 and over projected to reach at least 10% of the population, according to the 2025 Ageing and Health in the Philippines (Wave 2) study by ERIA and the UP-Population Institute.
This is an inflection point for families that already shoulder most long-term care at home. And that demographic turn is visible now.
Seniors accounted for 8.5% (9.22 million) of Filipinos in the Philippine Statistics Authority’s 2020 Census, while 8.7% of those aged five and above reported at least one functional difficulty, conditions that translate into daily care tasks in living rooms and kitchens rather than facilities.
Inside those households, women still do far more of this unpaid work. The 2021 National Household Care Survey data show they devote longer hours to care on a typical day and, when simultaneous supervision is counted, can spend the equivalent of another shift.
Meanwhile, global evidence is catching up with what families feel: mental health tends to worsen when people transition into unpaid caregiving, especially at higher care intensities, according to a 2024 Lancet Public Health longitudinal analysis.
In response, PhilHealth has begun funding outpatient mental-health services, ₱9,000 per year for general care and ₱16,000 for specialized care, benefits that caregivers themselves can tap.
TIRED? KEEP YOUR THOUGHTS HERE. IT MIGHT HELP YOU FEEL LIGHTER.
Faces of Care: “Parang Automatic”
At 4:30 a.m., 22-year-old Ana (not her real name), from Laguna, slips out of bed to check the hiss of her mother’s oxygen. She warms lugaw, lines up morning meds, then nudges her 10-year-old awake for online therapy. By 9 a.m., she’s on shift at a part-time job.
By dusk, she’s back to sponge baths and blood-pressure checks. Near midnight, she lies awake, trying to remember the last time she slept eight hours straight.
“I’m the eldest daughter. Parang automatic,” she says. “Kapag ako naman ang nauupos, sino ang sasalo?” (“When it’s me who burns out, who will step in for me?”)
“Hindi ako robot,” she murmurs, half-gasping. “Mahal ko sila, pero minsan, ubos na ubos na ako. Kahit isang oras lang na tulog na tuloy-tuloy, parang regalo na.” (“I’m not a robot… I love them — but sometimes I’m utterly drained. Even one hour of uninterrupted sleep would feel like a gift.”)
Across the Philippines, Ana’s day is ordinary in the most sobering way: constant, largely invisible care work falls heavily on women, and weighs on their minds.
Who Carries the Load? Mostly Women — and It’s Unpaid
Even before the pandemic, time-use evidence showed that Filipino women performed far more unpaid care and domestic work than men.
The 2021 National Household Care Survey (NHCS), conducted in January–March 2021 with PSA support, found women spend around 6.5 hours a day on care as a primary activity, almost triple men’s time; when simultaneous supervision is included, women’s care time can reach about 13 hours versus roughly 8 for men.
Those topline numbers were also reported in contemporaneous news coverage that summarized the same NHCS release.
Moreover, the care gap helps explain the persistent gender gap in paid work. The PSA’s labor data show men’s labor-force participation rates outpace women’s by wide margins.
For instance, GMA’s readout of PSA’s December 2023 figures reports 76.97% for men versus 56.27% for women. At the global level, the ILO warns that care responsibilities keep hundreds of millions of women out of the labor force, a stark measure of how unpaid care constrains women’s paid work and earnings.
International guidance now frames care as economic infrastructure, not just a “private family matter.” UN ESCAP’s 2024 Policymaker’s Guide explicitly urges governments, including the Philippines, to recognize, reduce, and redistribute unpaid care work, the “3Rs” — and to invest in services (from childcare to elder day-centers) that “buy time” for families.
The Mental Health Squeeze: What the Data Says
Caregiving’s psychological toll is measurable in Philippine studies. A 2021 hospital-based study of caregivers of children with neurodevelopmental disorders in Manila reported substantial rates of anxiety and depression and found that symptoms rose with caregiver burden.
In addition, separate clinical study among caregivers of Filipino children with epilepsy found significant caregiver strain and links between burden, poorer quality of life, and anxiety and depressive symptoms.
More recently, an abstract from the 2024 World Congress of Nephrology reported moderate caregiver burden and reduced quality of life among family caregivers of Filipino patients on hemodialysis, evidence that the pattern extends beyond pediatrics.
Globally, the arc is similar, and rigorously quantified. A 2024 longitudinal study in The Lancet Public Health tracking UK adults found psychological distress increases when people become unpaid caregivers, with impacts varying by caregiving intensity, age, and gender.
In parallel, a 2024 CDC analysis of U.S. survey data reported that caregivers consistently exhibited higher rates of frequent mental distress and diagnosed depression than non-caregivers — signs of how strain accumulates.
The pandemic also amplified these pressures. Using pooled Labor Force Survey data, a peer-reviewed study found women with minor children were significantly less likely to have paid employment during hard lockdowns than comparable women without children, a “parenthood penalty” that tightened both time and money in care-intensive households.
At the same time, distress indicators spiked: DOH data released in March 2021 showed the NCMH crisis hotline averaged 1,002 calls per month in early 2021, with local news later reporting year-to-date call totals in 2021 that nearly matched all of 2020.
PSA’s cause-of-death bulletin recorded a 57.3% rise in deaths due to intentional self-harm in 2020 versus 2019. And from a systems perspective, a WHO–DOH–UNDP investment case estimated mental-health conditions cost the Philippines ₱68.9 billion in 2019 (about 0.4% of GDP), mostly from lost productivity.
What the Law Says—and Where the Gaps Are
The Philippines put mental health into black-letter law in 2018. The Mental Health Act (Republic Act No. 11036) affirms the rights of service users and families to psychosocial care, participation in treatment planning, informed consent, privacy, and non-discrimination — principles later operationalized through DOH implementing rules.
Financing is slowly catching up. PhilHealth’s Outpatient Benefits Package for Mental Health, established by Circular 2023-0018 and highlighted again in a March 5, 2025 explainer, provides annual coverage of ₱9,000 for general mental-health services and ₱16,000 for specialized care, generally for members and dependents aged 10 and above.
Covered services include screening and assessment aligned with WHO’s mhGAP, diagnostics, up to 12 follow-ups, psychoeducation/psychosocial support, and select medicines in accredited facilities. Government and mainstream outlets echoed the same package amounts during rollout.
However, family-care leave remains patchy.
The Expanded Solo Parents’ Welfare Act (RA 11861) grants qualified solo parents seven days of paid parental leave annually important but limited for multi-year elder care or complex disability care.
Beyond that, the ILO’s Global Care Policy Portal lists “No long-term care leave” for the Philippines, leaving most caregiving absences to general leave or employer discretion.
Systems Trying to Catch Up
In places where poverty and conflict complicate access — think Maguindanao — the WHO Special Initiative for Mental Health (SIMH) has backed DOH to bring care closer to home.
WHO’s SIMH country materials note that Maguindanao’s 1.4 million residents long relied on few specialized services and a small mental-health workforce; the program trains nurses, midwives, and barangay health workers in mhGAP so basic assessment and support happen in primary care and at the community level.
More broadly, a 2024 SIMH poster states that more than 60% of primary care facilities nationwide now have at least one mhGAP-trained professional, a sign of growing capacity.
Digital tools are filling gaps for families who can’t easily step out. The Lusog-Isip mobile app, developed by USAID’s RenewHealth project with the Department of Health, launched in October 2021 with self-help exercises, mood tracking, journaling, and a referral network; it remains available on major app stores.
And the policy scaffolding is firming up. In October 2023, DOH and WHO launched the Philippine Council for Mental Health Strategic Framework 2024–2028 to guide expansion of services and benefits across agencies—an institutional step meant to lock in community-based, integrated care.
Practical Pathways: What Caregivers can Do Today
Tap what’s funded now. If you (or a dependent) are struggling with anxiety, depression, or related concerns, ask your primary-care provider or LGU clinic whether they’re accredited for PhilHealth’s mental-health packages.
According to PhilHealth Circular 2023-0018 and its annex, members and dependents aged 10+ may receive ₱9,000 per year for a general package and ₱16,000 for a specialized package, covering mhGAP-aligned assessment, diagnostics, up to 12 follow-ups, psychoeducation/psychosocial support, and certain medicines. PhilHealth’s March 2025 explainer reiterates those amounts and eligibility.
Use crisis lines — guilt-free. Round-the-clock help exists when you’re overwhelmed. The NCMH Crisis Hotline lists 1553 (nationwide landline toll-free) and mobile numbers on its official channels; directories also consolidate current numbers. In Touch Community Services operates a 24/7 Crisis Line, and the Visayas-based Tawag Paglaum – Centro Bisaya advertises 24/7 support. Calling for yourself as a caregiver is legitimate help-seeking.
Ask HR, early — and in writing. If you’re a qualified solo parent, cite RA 11861 to claim seven working days of paid parental leave per year. Keep a paper trail when requesting flexible schedules, telework days, or compressed workweeks; in practice, employer discretion often fills gaps that law has yet to cover.
Share the care — formally. Write down the weekly care plan (medication times, BP checks, therapy schedules) and share it with siblings or cousins so rotation nights are clear. The principle mirrors the “recognize, reduce, redistribute” approach that UN ESCAP recommends preventing caregiver burnout.
Consider digital bridges. If stepping out is hard, Lusog-Isip offers self-help exercises, mood tracking, and a referral directory; it launched with DOH support and remains available for free.
Why This Matters Now
Caregiving keeps Filipino families, and a sizable share of the economy, running. As the population ages and chronic conditions rise, the home will remain the front line of care. But caregiver mental health is a system risk: when caregivers burn out, hospitalizations rise, workdays are lost, and children’s well-being suffers.
Today’s tools are real, PhilHealth’s outpatient mental-health package, 24/7 crisis lines, and digital self-help, and so are the policy levers to pull next: caregiver-aware leave, community respite, mhGAP-ready primary care, and routine time-use data that reflect what households do.
Ana, the eldest daughter who checks the oxygen at dawn, finally called the NCMH hotline after a panic episode.
“I felt validated,” she recalls. “They said it’s normal to get tired. There’s help.” She booked a PhilHealth-covered consult the next week.
“I still do everything,” she says, “but I’m not alone anymore.”
Photo by Photo By: Kaboompics.com
DISCLAIMER
This article provides general information and does not constitute medical advice. Consult your healthcare provider for personalized recommendations. If symptoms persist, consult your doctor.
