The Silent Crisis: Mental Health, Family Separation, and the Invisible Wounds of Filipino Migration
An Investigative Analysis of the Psychological Toll on 10 Million Overseas Filipino Workers and Their Families Left Behind
For OFWs, Advocates, Policymakers, Mental Health Professionals, and Researchers
Introduction: The Price Beyond Remittances
Every day, approximately 6,000 Filipinos leave the country to work abroad. In 2024, the Philippines deployed 2.6 million overseas Filipino workers (OFWs) who sent home a record $38.34 billion in remittances—representing 8.3% of the nation’s GDP. Behind these impressive economic figures lies a crisis that remains largely invisible: the devastating mental health toll on migrant workers and the families they leave behind.
This investigation examines the psychological wounds that accompany migration—from the 12 documented suicides in Hong Kong between 2023 and 2025 to the estimated 1.5 to 3 million children growing up without one or both parents. It documents the systemic failures that leave workers without adequate mental health support, the abuse that compounds their trauma, and the broken families that represent the true “social cost” of the Philippines’ labor export policy.
The findings reveal that while the Philippine government has enacted progressive mental health legislation, implementation gaps leave OFWs as one of the most underserved populations. Mental health crises among migrant workers are not individual failures but systemic outcomes of exploitation, isolation, and institutional neglect.
Part 1: The Mental Health Emergency — Documenting the Crisis
1.1 Depression, Anxiety, and PTSD: The Research Evidence
A landmark 2022 study by Dr. Veronica Ramirez of the University of Asia and the Pacific, presented at the DOST National Brain & Mental Health Research Symposium, surveyed 884 OFWs across six Philippine regions and ten destination countries in Europe, the Middle East, and Asia. The findings painted an alarming picture of widespread psychological distress across the entire migration cycle.
Dr. Ramirez found that depression and anxiety were prevalent among OFWs at all stages of their employment journey—from pre-deployment through active employment to return. In Macau alone, 25 percent of surveyed workers exhibited symptoms of Post-Traumatic Stress Disorder, with similar PTSD prevalence documented among workers in Qatar, Indonesia, Nepal, and China. The study identified a spectrum of mental health conditions ranging from mild anxiety disorders to what Dr. Ramirez described as “disruptive and assaultive behavior” and “full blown episodes” of mental illness. Most troublingly, the research documented suicide cases within the study population.
A 2024 mixed-methods study by researcher Jamal Magantor provided complementary data by examining 50 OFW parents residing in Dubai and 50 of their children aged 8 to 18 living in the Philippines. Using the Depression, Anxiety, and Stress Scale (DASS-21), the study found that OFW parents had a significantly higher mean depression score of 16.3 compared to their children’s score of 14.4. Anxiety levels were similarly elevated in both groups, with parents scoring 18.1 and children scoring 18.6—indicating that children left behind experience anxiety at rates comparable to their parents working abroad. With an average separation length of 3.5 years, the study found a statistically significant positive correlation between the duration of family separation and psychological distress. Parents expressed profound regret over missing family milestones, while children reported persistent feelings of abandonment.
1.2 The Hong Kong Suicide Crisis: 2023-2025
The mental health crisis among OFWs has manifested most tragically in Hong Kong, where the Department of Migrant Workers has documented 12 suicides between 2023 and 2025. Six Filipino workers took their own lives in 2023, followed by four to five deaths in 2024, and at least one suicide as of April 2025. The most recent case involved a 44-year-old Filipina domestic helper found dead in a residence in Discovery Bay on April 16, 2025. Initial investigations indicated that financial struggles were the primary contributing factor.
During a Senate Committee on Migrant Workers hearing in April 2025, DMW Secretary Hans Leo Cacdac identified the key drivers behind this wave of suicides. Unpaid debts and aggressive harassment by loan shark collectors emerged as the most significant factor, with interest rates in Hong Kong reaching 48 percent—which, unlike in the Philippines, is legal under Hong Kong law. Cacdac also revealed a disturbing money laundering scheme in which OFWs are offered cash in exchange for surrendering their ATM cards or bank account information. These workers later discover that their accounts have been used for illegal activities, leading to arrests and criminal charges that compound their psychological distress.
OWWA Administrator Arnell Ignacio added another dimension to the crisis, noting that romantic relationship problems significantly contribute to mental distress among Hong Kong-based workers. The Tribune newspaper reported in April 2025 that from 2023 to 2025, at least 12 OFWs in Hong Kong “tragically ended their lives due to financial distress and emotional struggles,” with the publication calling for “urgent” strengthening of mental health support systems both within Hong Kong’s labor structure and in Philippine government agencies.
1.3 The “Forgotten” Workers: Barriers to Help-Seeking
A 2021 first-person account published in Rappler by an OFW working in Thailand laid bare the profound isolation that migrant workers face when experiencing mental health crises. The writer described a panic attack in November 2020 during the height of the pandemic, with labored breathing, racing heartbeat, and cold sweat. “It’s a feeling you just want to end—by any means necessary,” he wrote.
When the writer attempted to seek help, he encountered barrier after barrier. The only hospital in Phuket with outpatient psychiatric consultation services did not accept his work-provided health card, which was listed only for the government hospital—a facility that had no psychiatrists available. Private consultation would require him to pay out-of-pocket for sessions, therapy, and medications. “I decided to save my money instead,” he wrote, adding: “Money is more important than my depression—that was my initial mantra.”
Most devastatingly, when the writer searched for mental health crisis hotlines specifically for OFWs, he found none. “I wanted to talk to a Filipino,” he explained. “I want someone who could understand the context. I want someone who spoke my language.” The account illustrates the systemic barriers that prevent OFWs from accessing mental health support: language barriers in accessing local services, prohibitive costs that workers cannot afford while sending remittances home, the complete absence of Filipino-language crisis resources abroad, cultural stigma around mental health that prevents help-seeking, and the impossible calculus of choosing between personal wellbeing and family financial obligations.
The same article recounted the June 2020 suicide of Melvin Cacho, a 27-year-old Filipino teacher in Nonthaburi Province, Thailand. His suicide letter, found in his room, stated: “So stress[ed], anxiety, paranoid, family problem, job problem, money, failed dream. I can’t do this anymore. It hurts.”
1.4 Stressors Across the Migration Cycle
Dr. Ramirez’s research identified distinct stressors at each phase of the migration journey. During the pre-departure stage, workers face the financial burden of deployment costs—with research showing that 80.5 percent of workers go into debt to finance their overseas placement. They experience pressure to provide for families and anxiety about unknown working conditions in foreign lands.
Once employed abroad, OFWs confront a constellation of challenges including work environment stress, demanding job content and organizational conditions, culture shock and adaptation difficulties, social isolation far from family and community, and the ever-present risk of abuse and exploitation by employers. For those carrying deployment debts, repayment consumes approximately 20 percent of their monthly salary for an average of nine months or more.
The return stage presents its own psychological challenges. Workers face unemployment—with 87 percent remaining jobless three months after returning home according to IOM data—along with reintegration difficulties, disrupted family dynamics after years of separation, and the loss of identity that had been built around their role as overseas breadwinners. Dr. Ramirez noted that while mental health problems among OFWs are “not yet alarming,” they “may worsen over time if not enough attention is given to address them.”
Part 2: Children Left Behind — The Intergenerational Trauma
2.1 Scale of the Crisis
An estimated 1.5 to 3 million Filipino children are growing up with one or both parents working overseas. Government statistics indicate that seven percent of Filipino households have a family member working abroad, and a quarter of under-aged Filipinos are estimated to live separated from their parents due to overseas labor migration.
The gendered nature of contemporary migration has intensified the impact on children. Women now comprise 56 percent of all OFWs, reversing traditional household gender norms and challenging the Filipino cultural expectation that mothers serve as primary caregivers. When mothers migrate, research shows, children’s living arrangements are more likely to be disrupted compared to when fathers leave. This feminization of migration has created what scholars describe as a “care crisis” in Filipino communities, with profound implications for child development.
2.2 Psychological Impact on Children
A comprehensive scoping review published in The Lancet Regional Health – Western Pacific in 2022 examined the health status and available interventions for children left behind due to parental migration in the Philippines. The researchers found that familial cohesion in Filipino households serves as a key indicator for the severity of children’s mental illness, suicide ideation, and help-seeking behavior. Consequently, ruptures in the family unit that begin in early childhood “may inform long-term behavioural, cognitive, and emotional health outcomes, regardless of whether they are separated from one or both parents.”
A separate study published in PMC examining left-behind children across Southeast Asia, including the Philippines, found that children of migrant mothers face greater risk of poor mental health because most will have experienced separation from their primary caregiver. Higher levels of loneliness were consistently reported among children of Filipino migrants compared to their peers with parents at home. The researchers noted that while extended family members in the Philippines often provide alternative social support, this cannot fully protect children from what theorists call “emotional loneliness”—the lack of attachment that results from parental absence.
The documented psychological outcomes for children left behind include persistent feelings of loneliness and emptiness, melancholy and depression, emotional discomfort, increased school dropout rates, drug usage and behavioral problems, and attachment insecurity that affects their ability to form healthy relationships. A 2024 study examining cultural ideologies among 949 Filipino high school students, including 103 children of OFWs, found that contrary to expectations, left-behind children showed more negative attitudes toward people from other cultures and weaker interest in intercultural interaction. The researchers concluded that children may be “constructing their intercultural knowledge considering some negative information about OFW’s experiences”—suggesting that they internalize their parents’ stories of discrimination and exploitation rather than developing positive attitudes about the wider world.
2.3 The Gap in Government Response
Despite the scale of the crisis, government-institutionalized interventions for children left behind remain sparse. The Lancet scoping review identified 48 distinct interventions for affected children across the Philippines, but found that only three were implemented by the government nationwide. The remaining 45 programs were provided by local NGOs, with ATIKHA serving as the only civil society organization that has collaborated with government authorities on this issue.
The OWWA OFW Children’s Circle program aims to protect and develop the potential, skills, and talents of children-dependents of OFWs while addressing the social cost of migration on their mental health and wellbeing. However, this program reaches only a small fraction of the 1.5 to 3 million affected children. The review noted that while programs in other contexts such as Moldova and rural China have established government-institutionalized support systems for children of migrants, “similar government-institutionalized interventions remain absent in the Philippines.”
Part 3: The Marriage and Family Crisis
3.1 Marital Breakdown Among OFW Families
The strain of prolonged separation has devastated countless Filipino marriages. A retired Family Court Judge in Baguio-Benguet estimated that 75 percent of OFW couples in the region undergo annulment or legal separation. Judge Francis Buliyat Sr., speaking from his experience presiding over family cases, observed that the typical pattern involves a wife working abroad who discovers that her husband has started another family during her absence. “I have to be candid,” he said, “that there are more separated couples that have been annulled because you have a situation wherein the wife goes abroad… and finds out that the husband has another family.”
Judge Buliyat’s conclusion was stark: “While the OFW is really good for the economy of the country, I think it is not good for the families of our country.”
A 2009 report from the National Commission on the Role of Filipino Women found that marital infidelity was one of the major causes of stress among Filipino couples, with approximately 36 percent of men and two percent of women engaging in extramarital affairs. The dynamics of OFW families compound these problems in both directions. Workers abroad, isolated from spouses and facing intense loneliness, may seek emotional or physical comfort from others. Meanwhile, family members left behind struggle with their own loneliness and may find themselves drawn into relationships outside the marriage. Both scenarios lead to trust issues, emotional pain, and ultimately broken families.
For OFWs experiencing marital breakdown, the challenges are compounded by distance. A 2024 Rappler investigation quoted Cici Leuenberger-Jueco, convenor of the pro-divorce lobbying group Divorce for the Philippines Now, who noted that the majority of the organization’s approximately 100,000 members are overseas Filipino workers. “The ones leaving to be OFWs usually have financial problems in the Philippines,” she explained. “This leads to them always fighting to begin with.” Physical separation then makes it impossible to work through problems in real-time. “Many OFW women have guilt,” Jueco added. “They already have so many problems—from their employers, to their contracts, to their loneliness and homesickness. Then you have to deal with your marriage breaking down, and you cannot even guide your children through it.”
3.2 The Philippines Without Divorce
The Philippines remains the only country in the world, aside from the Vatican, where divorce is not legal. This creates unique burdens for OFWs trapped in failed marriages. The only legal options for ending a marriage are annulment, which requires proving that one spouse was psychologically incapable of fulfilling marital obligations, or declaration of nullity based on specific grounds such as bigamy.
The annulment process is prohibitively expensive and time-consuming for most Filipinos. Average costs run to eight to twelve months of Metro Manila median household income, with processing taking an average of 3.8 years and yielding only an 82 percent success rate. According to the Philippine Statistics Authority, just 1.9 percent of Filipinos have either received an annulment or gotten separated or divorced—the latter category including those who wed overseas.
For OFWs, the situation is particularly complex. Workers face host-country legal complications when they cannot dissolve Philippine marriages, creating problems with documentation, benefits, and relationships formed abroad. They also become targets for scammers who prey on their desperation. Jueco warned that OFWs are frequently approached with offers to process fake “Muslim divorces” through Sharia courts for prices around ₱200,000. Under the Code of Muslim Personal Laws, divorce provisions only apply to marriages where both parties are Muslim or where the man is Muslim and the marriage was solemnized under Muslim law—making these offers fraudulent. “There are so many OFWs who fall for it,” Jueco said. “Sometimes, they don’t have access to news, so they get wrong information from YouTube, TikTok, or Facebook.”
Public opinion has shifted dramatically on this issue. A December 2024 Social Weather Stations survey found that 62 percent of Filipinos now support allowing irreconcilably separated couples to divorce, up from 43 percent in 2005. The House of Representatives passed the Absolute Divorce Bill in May 2024, but it remains pending in the Senate as of late 2025.
Part 4: Workplace Abuse and Its Psychological Toll
4.1 The Prevalence of Exploitation and Violence
Research from multiple sources documents the widespread abuse of Filipino migrant workers, particularly domestic helpers who work within the private confines of employers’ homes. A 2016 report by the Justice Centre in Hong Kong found that 18 percent of domestic workers surveyed had suffered physical abuse, 66 percent were victims of exploitation, and one in six were in situations that met the definition of forced labor.
A Stanford University survey of Filipino and Indonesian domestic workers who had returned from employment in Arab Gulf states found that more than 50 percent of respondents had experienced at least one type of abusive situation. The most common abuses were economic in nature: excessive working hours, late payment of wages, and denial of days off. Twelve percent reported having limited access to food, seven percent experienced forced confinement, seven percent reported complete non-payment of salary, six percent were denied medical treatment when ill or injured, four percent suffered physical abuse, and two percent experienced sexual attacks. Given that Saudi Arabia alone has more than three million migrant domestic workers according to ILO estimates, these percentages represent hundreds of thousands of women facing abuse.
Data from the Philippines’ Department of Migrant Workers shows a dramatic increase in documented violations in Kuwait specifically. In 2022, more than 24,000 violations and abuses of Filipino workers were reported—a marked increase from 6,500 in 2016. This nearly fourfold increase may reflect both rising abuse and improved reporting mechanisms, but either interpretation points to a crisis requiring urgent intervention.
4.2 Case Studies in Tragedy
Behind these statistics lie individual tragedies that have shocked the Philippines and prompted calls for systemic change. In January 2022, the body of 35-year-old Jullebee Ranara was found burned in a Kuwaiti desert. She was pregnant at the time of her death. Her employer’s 17-year-old son was later convicted of her murder and sentenced to 15 years in prison. The case sent shockwaves across the Philippines and sparked calls for a deployment ban to Kuwait.
Joanna Daniela Demafelis, 29, was found inside a freezer in an abandoned apartment in the Al Shaab district of Kuwait in 2018. Her body was in a sitting position with arms crossed. Her family in an agricultural community in Iloilo had not heard from her in two years. Autopsy reports revealed that Joanna had been dead for over a year and had suffered broken ribs and internal bleeding before she died. She was killed by her employers, Mouna Ali Hassoun and her husband Nader Essam Assaf.
In August 2024, Senator Raffy Tulfo brought before the Senate Committee on Migrant Workers the cases of Jelyn Arguzon and Riolyn Sayson, two Filipinas who died in Saudi Arabia within weeks of each other. Arguzon’s husband had lost contact with his wife after her employer took her passport and limited her communication with family. She was reported dead of “natural causes” in July 2024. Sayson, according to her husband’s account relayed by Tulfo, was locked in her room by employers, fed only one meal a day, and complained of back pains and shortness of breath before dying of what Saudi officials termed “cardiac arrest.”
Irma Edloy, a 35-year-old domestic worker in Saudi Arabia, fell into a coma after being violently assaulted and raped by her employer. DMW Secretary Hans Cacdac visited her in the hospital. “Irma died few hours after our visit,” Cacdac recounted, visibly upset when discussing the case.
4.3 Structural Factors: The Kafala System and Live-In Requirements
Two structural factors compound the vulnerability of Filipino domestic workers to abuse. The kafala or sponsorship system used in most Gulf states ties workers’ legal status entirely to their employer-sponsor. Workers can only work for their sponsor for the length of their contract, typically two years. If the employer breaks the contract, the worker’s visa is immediately cancelled and they face deportation. This gives employers enormous power over workers, who may not report abuse for fear of retaliation that could cost them their job, their legal status, and their ability to support families back home. Some reforms are underway—the UAE began allowing migrant workers to change jobs without employer approval in 2011, and Qatar enacted similar reforms in 2020—but implementation remains inconsistent.
In Hong Kong, the mandatory “live-in” requirement forces all foreign domestic workers to reside with their employers regardless of how they are treated. Workers who experience continuous insults, abuse, or threats of violence have no legal right to live elsewhere, even during their limited time off. During the COVID-19 pandemic, this policy left many workers effectively imprisoned in abusive households, with some reporting that they worked 24 hours on-call for eight or nine months without a single day off. A February 2025 judicial review in Hong Kong dismissed all challenges to the live-in policy.
A United Nations report published in March 2024 called for Hong Kong to amend both the “two-week rule”—which gives terminated workers only 14 days to find new employment or leave the territory—and the live-in requirement. The report also urged Hong Kong to extend its statutory minimum wage to migrant domestic workers, who currently receive a separate “minimum allowable wage” that is 22 percent lower than what other workers in the city receive.
Part 5: The Mental Health System — Resources and Gaps
5.1 The Philippine Mental Health Act and Its Implementation
The Philippines enacted its first Mental Health Act, Republic Act 11036, in June 2018. The landmark legislation established that all Filipinos have a basic right to mental health and created a comprehensive framework for mental health services. The law mandated the creation of the Philippine Council for Mental Health as an oversight body, required the integration of mental health into educational curricula, called for workplace mental health programs, and established standards for capacity building among mental health professionals.
Implementation has progressed, though significant gaps remain. As of 2023, the Department of Health reported that 362 access sites nationwide now cover 27 priority mental health medicines, serving more than 124,000 service users. The national network includes 75 mental health facilities, with 23 designated as specialty care centers and 52 as acute and custodial care facilities. More than 1,556 personnel have completed WHO Quality Rights e-training.
However, the workforce shortage remains critical. The Philippines has approximately 1,530 registered mental health professionals serving a population of more than 100 million people—fewer than one mental health worker for every 100,000 Filipinos. Senator Christopher Go, chair of the Senate Committee on Health and Demography, noted during a 2023 oversight hearing that the National Center for Mental Health requires “utmost attention and improvement.” Senator Sherwin Gatchalian highlighted that the country has 60,000 schools but only 1,500 registered guidance counselors, creating what he called a “massive shortage” in implementing mental health programs for youth.
5.2 OFW-Specific Mental Health Services
Several government initiatives specifically target OFW mental health, though coverage remains limited. OWWA provides psychosocial counseling services through its regional and overseas offices, and the Welfare Assistance Program extends support to members experiencing distress. In July 2025, OWWA announced a partnership with LoveYourself Inc., an advocacy organization, to provide free mental health services and HIV testing to OFWs. Services are available at the OWWA Seafarer’s Hub in Ermita, Manila, and at LoveYourself clinics. The partnership also launched the “Embrace Virtual Hub” to provide online access to HIV prevention, STI treatment, and mental health support.
Department Administrative Order 4 s. 2025 established that Migrant Worker Offices abroad must “ensure the safety and provide appropriate care and assistance to OFWs exhibiting symptoms of mental illnesses.” The One Repatriation Command Center operates a 24/7 hotline for OFWs in distress. Following the Hong Kong suicide crisis, DMW partnered with the Hong Kong Police Force to crack down on loan sharks who aggressively harass Filipino borrowers.
Research continues to shape policy development. A 2021 study by the Davao Medical School Foundation examined the acceptability of telepsychiatry among OFWs in Kuwait and found that 40 percent of 55 participants had experienced mental health challenges, with acute stress disorder and major depressive disorder being the most common diagnoses. OFWs expressed high acceptance of telepsychiatry services, suggesting a potential pathway to overcome barriers of cost and access. Researchers are now coordinating with DMW-OWWA to assess the feasibility of implementing a telemental health program for OFWs across multiple destination countries.
Dr. Ramirez’s research has produced specific recommendations for strengthening OFW mental health support. She found that rather than simple psychological testing, what is needed is a comprehensive psychosocial evaluation tool that can measure readiness for overseas work across multicultural, socio-economic, emotional, and psychological dimensions. She has also called for intensive awareness campaigns to break the barriers to help-seeking, and for the establishment of more psychiatric and psychological services in the major OFW-sending regions of the Philippines.
5.3 The International Dimension
Mental health support for OFWs requires action not only from the Philippines but from destination countries as well. In Hong Kong, the estimated suicide rate reached 14.1 per 100,000 in 2024, above the global rate of 8.9 per 100,000. Young adult males aged 25 to 39 saw their suicide rate surge from 10.0 in 2021 to 14.4 in 2024, largely due to financial issues, with unemployed individuals facing a suicide risk five to six times greater than their employed peers. Domestic workers, who are excluded from most public mental health services and whose healthcare access is largely determined by employers’ willingness to allow them to seek care, represent a particularly vulnerable population within this already concerning landscape.
Across destination countries, OFWs face common barriers to mental health support. Language difficulties prevent them from accessing local services. Adverse working conditions leave little time or energy for self-care. There is a shortage of healthcare providers familiar with migrants’ specific needs. Social protection systems often exclude temporary foreign workers. And the power imbalance between employers and live-in workers creates hesitation to seek help that might jeopardize employment.
Part 6: The Reintegration Crisis
6.1 Unemployment and Economic Distress Upon Return
The challenges facing OFWs do not end when they return home. Research consistently documents devastating unemployment rates among returned workers. An International Organization for Migration impact assessment conducted in 2021 found that 87 percent of returnees remained unemployed three months after coming home, while 96 percent had not received any reintegration assistance. The 2018 National Migration Survey found that seven in ten returning migrants reported difficulties finding a job or establishing a business within three months of their return.
The COVID-19 pandemic amplified these challenges. As hundreds of thousands of OFWs were repatriated in 2020 and 2021, they returned to a Philippines grappling with an unemployment rate that had doubled from 5.1 percent in 2019 to 10.3 percent in 2020. Data showed that 83 percent of OFWs remained unemployed three months after pandemic-related return. A 2023 study by a group of university researchers identified reintegration as “the weakest link” in the country’s migration policies.
Arman Hernando, chairperson of migrant rights group Migrante Philippines, raised pointed questions about the gap between deployment numbers and support capacity. “The latest government figures mean we are sending 6,800 Filipinos per day abroad,” he noted. “More and more Filipinos can be at risk, especially in conflict areas, if we fail to properly monitor all of them. Are we deploying more Filipinos than we can protect?”
6.2 The Case of Lucy Ortega
The story of Lucy Ortega illustrates the failure of reintegration support. Trafficked into servitude in Syria for eight years, Ortega eventually escaped and sought help at the Philippine Embassy—where she was stranded in a shelter for two more years, an episode that made global headlines. When she finally returned to the Philippines, she received ₱10,000 in government assistance—and nothing more. No trauma counseling. No help finding work. No compensation for the embassy ordeal. No assistance recovering the wages stolen by her Syrian employer.
Today, Ortega leads a support group of 52 trafficked domestic workers repatriated from Syria, all of whom received the same minimal assistance. She works part-time in a lottery outlet, earning less than minimum wage while supporting three children in school. “I need a stable job for my three children who are still in school,” she told reporters. “I need justice, but I also need money.”
Hernando identified the core problem with current government response: agencies offer emergency assistance but not comprehensive reintegration planning. “Such an approach would also encourage the country’s migrant labor force to come home,” he argued, “helping to build national industry and sustain the economy’s long-term growth.”
6.3 Government Reintegration Programs
The National Reintegration Center for OFWs operates under the Department of Migrant Workers with a mission of enabling OFWs and their families to work with an entrepreneurial mindset, primarily through creating awareness about the value of saving and empowering them to plan for investment, business, or local employment upon return. The center also responds to the reintegration needs of displaced OFWs and those affected by crises abroad.
In November 2024, OFW Party-list Representative Marissa Magsino filed House Bill 11130, which would establish a holistic and sustainable reintegration program addressing the economic, social, and psychological challenges OFWs face upon return. “Our OFWs have long been pillars of our economy, providing essential foreign exchange remittances that fuel the nation’s growth and development,” Magsino said. “But for many of them, returning home comes with its own set of challenges—finding employment, starting a livelihood, and reuniting with their families after years apart.”
The government is also considering expanding AKSYON Centers to key regions to enhance service accessibility for transitioning OFWs. These centers provide one-stop services including financial assistance, livelihood support, and psychosocial counseling.
Part 7: Systemic Reform Recommendations
7.1 For the Philippine Government
Addressing the mental health crisis among OFWs requires action across multiple government agencies and throughout all phases of the migration cycle. The development of an OFW-specific psychosocial evaluation tool should be prioritized—one that measures readiness for overseas work across multicultural, socio-economic, emotional, and psychological dimensions, rather than relying on simple psychological tests that fail to capture the complexity of migration stress.
The establishment of Filipino-language mental health crisis hotlines accessible from all major destination countries would address one of the most critical gaps identified by workers themselves. As the OFW in Thailand wrote: “I wanted to talk to a Filipino. I want someone who could understand the context.” Current hotlines are limited in geographic reach and often inaccessible during the hours when crises occur.
The 2015 Joint Manual of Operations between DFA, DOH, DSWD, OWWA, and the former POEA should be revised to include mandatory mental health assistance at all stages of migration. This would institutionalize mental health support rather than leaving it as an add-on service. Additionally, increasing the number of psychiatrists and psychologists in major OFW-sending regions would address the critical workforce shortage that currently leaves fewer than one mental health professional for every 100,000 Filipinos.
The implementation of a telepsychiatry program for OFWs, building on the successful Kuwait feasibility study, could leverage technology to overcome barriers of cost and access. Such a program could provide culturally and linguistically appropriate mental health services to workers regardless of their location abroad.
7.2 For Destination Countries
Hong Kong should extend its statutory minimum wage to domestic workers rather than maintaining a separate, lower rate. The territory should reform the “two-week rule” that penalizes workers who change employers, and should abolish or modify the mandatory live-in requirement that enables abuse by trapping workers in employers’ homes around the clock. Implementation of the proposed HK$5,000 loan cap and Credit Data Smart system would help address the debt crisis that has driven so many workers to suicide.
Gulf countries should accelerate reforms to the kafala system to allow genuine job mobility, enabling workers to leave abusive employers without losing their legal status and ability to work. They should strengthen enforcement of existing anti-abuse laws, which often remain on the books but are rarely applied. Providing workers with clear information about their rights in their own language, and mandating that employers provide access to mental health services, would further protect vulnerable workers.
7.3 For Employers and Recruitment Agencies
Employers hiring OFWs should implement mental health awareness programs and provide Employee Assistance Programs with confidential counseling services. Workers must have regular communication access with their families—research shows this directly reduces anxiety levels. Supervisors should be trained to recognize signs of mental distress, and reporting mechanisms should be established that protect workers’ immigration status when they raise concerns about abuse.
Recruitment agencies that profit from OFW deployment must be held accountable for the welfare of workers they place. This includes pre-deployment screening for readiness, maintaining contact with deployed workers to identify problems early, and providing support when workers return in distress.
7.4 For OFWs and Families
Workers preparing to go abroad should understand their rights under RA 11036 and the laws of their destination country. Maintaining regular communication with family members is not merely emotionally comforting but has been shown in research to reduce anxiety levels for both workers and children left behind. Building social support networks with fellow workers provides a safety valve when stress accumulates. Workers should access available mental health resources before reaching crisis point rather than waiting until a situation becomes desperate.
Families in the Philippines should discuss mental health openly to reduce the stigma that prevents help-seeking. They should seek psychosocial support for children showing signs of distress, rather than assuming that material provision can substitute for parental presence. Maintaining regular communication schedules with OFW parents helps children feel connected. Building extended family and community support networks ensures that children and spouses are not isolated when the OFW parent is away. And addressing relationship problems promptly—rather than allowing them to fester during long separations—can prevent the complete breakdown that affects so many OFW families.
Emergency Resources
When crisis strikes, Filipino workers and their families can reach out to several resources for immediate assistance. The DMW Hotline at 1348 operates 24 hours a day, seven days a week, providing assistance to distressed OFWs including support for repatriation. OWWA can be reached at the same number for welfare assistance and psychosocial support. The National Center for Mental Health in the Philippines can be contacted at (02) 8989-8727 for crisis intervention and psychiatric services. HOPELINE Philippines at 0917-558-4673 provides suicide prevention counseling.
For OFWs in Hong Kong specifically, the Philippine Consulate can be reached at 9155-4023 for consular assistance, while POLO-OWWA is available at 6345-9324 for labor and welfare support. In Thailand, the Samaritans of Thailand offers an English-language crisis line at +66 2-713-6793. HELP for Domestic Workers in Hong Kong provides legal assistance and emergency shelter for workers escaping abusive situations.
Conclusion: Beyond Economic Metrics
The Philippines’ labor export policy has generated $38 billion in remittances but produced unmeasurable psychological costs. The 12 suicides documented in Hong Kong from 2023 to 2025 represent only the visible tip of a mental health crisis affecting millions of OFWs and their families. For every worker who takes their own life, countless others struggle in silence with depression, anxiety, and trauma that go undiagnosed and untreated.
The evidence presented in this investigation reveals systemic failures across the entire migration cycle. Before departure, workers receive inadequate psychological screening and preparation for the challenges ahead. During employment abroad, they face exploitation, abuse, and isolation without accessible mental health support in their own language. Upon return, they encounter unemployment, broken families, and insufficient reintegration assistance that fails to address either their economic or psychological needs.
The Philippine Mental Health Act of 2018 established important frameworks for protecting the mental health of all Filipinos. But with fewer than one mental health professional per 100,000 people, no dedicated OFW mental health hotline, and interventions that reach only a fraction of those in need, the gap between legislation and implementation remains vast.
Children pay perhaps the highest price for this gap. The 1.5 to 3 million Filipino children growing up with absent parents experience documented increases in depression, anxiety, loneliness, and attachment insecurity. They struggle with feelings of abandonment, show increased rates of school dropout and drug use, and develop negative attitudes toward the wider world based on their parents’ stories of discrimination and exploitation. Government interventions reach only a small percentage of these children, leaving most to cope with family rupture on their own.
Reform requires action at multiple levels simultaneously. The Philippine government must strengthen mental health services specifically for migrants, from pre-departure screening through employment abroad to reintegration support upon return. Destination countries must reform structures like the kafala system and live-in requirements that enable abuse. Employers and recruitment agencies must take responsibility for worker welfare beyond mere placement. And families must address the psychological dimensions of migration rather than focusing solely on economic outcomes.
Ultimately, addressing the mental health crisis among OFWs requires questioning whether remittances can ever justify the human cost. As long as the Philippines relies on labor export as an economic strategy, it has an obligation to protect not just the economic rights but the psychological wellbeing of the workers who sacrifice so much for their families and their nation.
For Melvin Cacho, the 27-year-old teacher who took his life in Thailand after writing of his stress, anxiety, paranoia, family problems, job problems, and failed dreams—for the 12 workers who died by suicide in Hong Kong—and for the millions of OFWs who struggle every day in silence—mental health is not a luxury that can be deferred until they return home. It is a fundamental right that must be protected throughout the migration journey.
If you or someone you know is experiencing a mental health crisis, please reach out to available resources. You are not alone.
About This Investigation
This article synthesizes research and reporting from multiple sources including the landmark studies by Dr. Veronica Ramirez of the University of Asia and the Pacific presented at the DOST-PCHRD National Brain & Mental Health Research Symposium in 2024; the comprehensive scoping review published in The Lancet Regional Health – Western Pacific in 2022; PMC studies examining left-behind children and migrant worker mental health across Southeast Asia; DMW enforcement data and Senate Committee on Migrant Workers hearing testimony from 2024-2025; International Organization for Migration assessments of returned OFW reintegration; the ICIJ Trafficking Inc. investigation of 2023; Hong Kong media investigations by the South China Morning Post and Hong Kong Free Press in 2024-2025; the mixed-methods family psychological distress study by Jamal Magantor published in 2024; and first-person accounts by OFWs published in Rappler and other outlets.
