Adolescent Self-Harm in the Filipino Context: A Current Challenge for Philippine Social Work

Growing concerns

Filipino adolescents make up 28% of the Philippine population (Ramachandran, 2024). While this presents immense potential for national development, many continue to face challenges that affect their mental health and overall well-being. For instance, a recent study reports that one in eight Filipino adolescents aged 10-19 lives with a mental disorder (UNICEF East Asia and Pacific Regional Office et al., 2022). At the same time, rates of suicide attempts and self-harm among adolescents have been increasing over the past years (Alberto et al., 2025). However, despite the growing need for support, access to mental health services remains limited and fragmented (Lally et al., 2019).

How common is self-harm?

Self-harm refers to the intentional infliction of pain or injury on oneself. In this article, the focus is on non-suicidal self-injury (NSSI), which is a form of self-harm carried out without the intention to die (Masana et al., 2020). In general, self-harm is a significant public health concern because it is closely associated with psychological distress and an increased risk of future self-harm and suicidal behavior (Malazarte, 2025).

Recent studies suggest a high prevalence of self-harm among Filipino adolescents. For instance, in a sample of 1,229 adolescents, Alberto and colleagues (2025) found that more than one-third (34.2%) had engaged in self-harm. Similarly, in an earlier research, Ty and others (2019) reported that 63% of participants (n = 309) had a history of NSSI. Meanwhile, a study involving 225 Filipino college students (mostly in late adolescence) found that 33.8% had engaged in self-harm, with 26.2% reporting NSSI and 14.7% reporting a suicide attempt (Galicia & Bautista, 2017).

Although differences in study populations, definitions, and measurement tools may account for variations in prevalence estimates, these findings consistently highlight self-harm as an important mental health concern among Filipino adolescents.

How Filipino researchers explain it

Social work research on self-harm among Filipino adolescents remains limited, but existing studies from other disciplines consistently show that self-harm is closely linked to emotional distress and difficulties in coping.

For instance, Capay (2012) found that Filipino adolescents who engage in NSSI primarily use self-harm as a maladaptive coping strategy to express negative feelings, translate emotional pain into physical pain, elicit positive emotions, and to escape or signal rebellion. The study also associated NSSI with depressive symptoms, suicidal tendencies, impulsivity, family discord, low self-worth, negative self-perceptions, peer insecurity, and limited social support, highlighting the broad vulnerabilities linked to the behavior.

Similarly, Masana, Reyes, and Delariarte (2020) link NSSI to personality traits such as emotional instability and borderline features, and suggest that self-harm behavior is often experienced as a way of coping with overwhelming negative emotions. Drawing from interviews, they describe NSSI-related behavior as moving through three states (disturbed, diverted, and devitalized) shaped by both personality factors and cultural influences such as shame, sensitivity to judgment, and self-image.

Expanding the understanding of risk and protection factors, Malazarte (2025) recently identified academic stress, low socioeconomic status, and family problems as key contributors to NSSI among Filipino senior high school students. In contrast, access to professional psychological support and spiritual guidance emerged as important protective resources.

Collectively, these studies suggest that self-harm among Filipino adolescents is shaped by interacting emotional, interpersonal, and contextual factors, underscoring the importance of both formal and informal care systems in prevention and intervention.

Sources of ‘bigat’ and ‘gaan’

For Filipino adolescents with self-harm experiences, distress is often described through the metaphors ‘bigat’ and ‘gaan,’ reflecting their “pakiramdam” (general feeling). To them, bigat conveys the emotional burden that can intensify distress and trigger self-harm urges, while gaan represents relief and comfort gained through support. Together, these metaphors offer a culturally grounded lens for understanding how they make sense of their struggles and coping responses.

Drawing from the author’s casework experience in hospital and mental health nonprofit settings, several recurring patterns emerge in what adolescents commonly describe as sources of bigat and gaan:

1. The Family

The prominence of the family in this discussion is perhaps unsurprising, given that it consistently emerges as a central source of both bigat and gaan for many Filipino adolescents.

When adolescents identify their “pamilya” (family) as a source of bigat, it often stems from specific forms of “gulo” (tension or conflict) within family relationships, such as unmet needs and expectations, breakdowns in trust, enduring relational discord, or other interpersonal difficulties. Given the central role of the family in Filipino life, these tensions appear to contribute to deeper emotional strain, placing adolescents at greater risk of self-harm.

In contrast, the family may also serve as an important source of gaan in other instances, even among adolescents who have experienced self-harm thoughts or behaviors. Some communicate strong attachment to their families by expressing care, responsibility, and hope for improved relationships. In this context, the family functions as a protective factor that maintains safety.

2. Peer Relationships

When the family is experienced as a source of bigat, peer relationships often become an alternative source of gaan for Filipino adolescents. Across accounts of self-harm-related distress, the “kaibigan” (friends) or “barkada” (trusted peer networks) are frequently described as key spaces for sharing burdens that might otherwise be carried alone. These relationships serve as protective spaces that help interrupt the escalation of distress, even if only temporarily.

However, it is important to note that peers are not automatically a source of gaan. In some instances, they may also become a site of bigat, if not the primary cause for self-harm thoughts or urges, particularly in contexts where bullying or peer victimization is experienced by Filipino adolescents.

3. Academic Pressure

Academic expectations also appear to contribute significantly to feelings of bigat in the context of self-harm-related distress. This is especially true for Filipino adolescents, who often experience pressure in relation to broader meanings attached to education, such as a way of “pagsukli sa sakripisyo ng mga magulang” (repaying parents’ sacrifices) or “pag-asenso sa buhay” (improving one’s life).

Given such, struggles in school may be interpreted by an adolescent not only as performance issues, but also as signs of failure in meeting expected life objectives. This often contributes to increased emotional distress, including feelings of hopelessness, worthlessness, or overwhelm that may lead to risk of self-harm.

4. Social Judgment

Another recurring source of bigat in the self-harm experiences of Filipino adolescents is the anticipation or experience of social judgment. For many, this is closely tied to “hiya,” which is a sense of shame shaped by concerns about "ang sasabihin ng iba" ("what others will say").

As adolescents navigate their social relationships, many worry about being misunderstood, dismissed, or not taken seriously when expressing distress, including self-harm concerns. This creates a layered burden, where such thoughts or feelings are compounded by fear of disclosure, deepening isolation and making it harder to seek support.

5. Religion and Moral Beliefs

For some Filipino adolescents with self-harm-related thoughts or experiences, religious and moral beliefs (or “paniniwala” in Filipino) appear to provide a source of gaan. Often, they describe faith as helping them make sense of their distress. While it does not eliminate emotional pain, it seems to offer them moral boundaries, reasons to resist urges, and sources of hope.

However, gaan from beliefs is also not universal. For some adolescents, religious or moral beliefs can instead become a source of bigat, particularly when they have had difficult experiences within their faith-based communities.

6. Creativity, Recreation, and Meaningful Activities

Many Filipino adolescents with self-harm experiences turn to meaningful activities, often referred to as “libangan” (a collective term that denotes amusement, recreation, and relaxation), as a way of coping. These may include creative expression such as writing, music, and drawing, as well as sports, online gaming, volunteering, or participation in school and community life.

Beyond distraction, these activities foster gaan by offering safer outlets for emotional expression and brief relief from emotional pressure. They can also create spaces for connection with others, and in some cases, interrupt cycles of distress, making self-harm thoughts or urges feel less overwhelming.

7. Inner Resilience

Despite experiences of self-harm and distress, many Filipino adolescents often cite “tatag ng loob” (a Filipino term often used to refer to resilience) as a resource for coping and moving forward. They continue to draw from this sense of inner strength to stay connected to daily life and to others through relationships, routines, aspirations, and small sources of relief, even as different sources of bigat that contribute to self-harm thoughts or urges remain present.

Although tatag ng loob can help adolescents find a sense of gaan, it mainly helps them endure experiences of bigat, rather than make the burdens disappear. Therefore, it should not be seen as a complete guarantee against risks of self-harm.

What this means for Philippine Social Work

Overall, the concepts of bigat and gaan offer a meaningful way of understanding self-harm among Filipino adolescents. For Philippine social work, these insights highlight the need for approaches that are both culturally responsive and systemic in nature. They call on social workers to understand adolescent self-harm through a person-in-environment lens, situating young people's experiences within their broader familial, social, cultural, and even political contexts.

In this light, Filipino social workers must recognize that effective responses extend beyond individual-level interventions. Instead, they should also seek to strengthen family relationships, foster supportive peer networks, reduce stigma, improve access to mental health services, and enhance adolescents' overall quality of life. Such a holistic approach echoes Osborne and Warria's (2025) call for social workers to serve as agents of change by addressing not only individual distress, but also the broader social conditions that shape well-being.

As a challenge moving forward, social work practice in the Philippines should aim not only to confront—and, where possible, transform—the sources of bigat, but also to build and strengthen the systems that facilitate gaan, helping Filipino adolescents cope, heal, and live free from the risk of self-harm.

References:

Alberto, D. H., Tan, R. C., Guevarra, J. P., Reyes, A. S., Peñalba, I., Abio, A., Sourander, A., & Maravilla, J. C. (2025). Suicidal behaviours and self-harm among adolescents: Results from a school-based mental health survey in the Philippines. Global Mental Health, 12, e150. https://doi.org/10.1017/gmh.2025.10105

Capay, A. R. (2012). Non suicidal self injury: Methods, functions and psychosocial functioning of Filipino youth who self injure, eight cases [Master’s thesis, De La Salle University Manila]. Animo Repository. https://animorepository.dlsu.edu.ph/etd_masteral/6857

Galicia, J. R., & Bautista, T. (2017). Prevalence of nonsuicidal self-injury and suicide attempt among young adult university students. Acta Medica Philippina, 51(4), 295-302.

Lally, J., Tully, J., & Samaniego, R. (2019). Mental health services in the Philippines. BJPsych international, 16(3), 62-64. https://doi.org/10.1192/bji.2018.34

Malazarte, N. (2025). Prevalence of non-suicidal self-injury in senior high school students: Basis for intervention program. Psychology and Education: A Multidisciplinary Journal.

Masana, L.P., Reyes, M.E., & Delariarte, C.F. (2020). Unraveling non-suicidal self-injury: Understanding the behavioral dynamics of Filipino adolescents at risk of deliberate self-harm. North American Journal of Psychology, 22(2), 331-354.

Osborne, K., & Warria, A. (2025, November). Reclaiming clinical social work: Responding to global politics through emancipatory social justice-engaged practice. Social Dialogue, 30. https://www.socialdialogue.online/sd30/article18.html

Ramachandran, S. (2024, October 8). Empowering Filipino youth for a resilient future. United Nations Development Programme Philippines. https://www.undp.org/philippines/press-releases/empowering-filipino-youth-resilient-future

Ty, D. S. Y., Rivas, M. N. C., Regalado, J. A., & Arranz-Lim, M. T. G. (2019). A cross-sectional study on non-suicidal self-injury (NSSI) among Filipino middle adolescents (14-17 years old) enrolled in select private schools in Metro Manila using the Inventory of Statements About Self Injury (ISAS). In CSMC Research Abstract 2019 Compendium. Cardinal Santos Medical Center.

UNICEF East Asia and Pacific Regional Office, Research Institute for Mindanao Culture, & Burnet Institute. (2022). Strengthening mental health and psychosocial support systems and services for children and adolescents in East Asia and the Pacific region: Philippines country report. UNICEF. https://www.unicef.org/philippines/reports/strengthening-mental-health-and-psychosocial-support-systems-and-services