No one is suggesting that a deficiency in the Baltimore program resulted in the deaths. If anything, some say, what the suicides reveal is the deeply stigmatizing nature of mental illness among Filipinos, even among those who come to this country.
The Philippines is a deeply religious Roman Catholic society, with a close-knit family structure that takes care of its own. Many Filipinos say that, in their culture, it's generally accepted that in times of personal turmoil, people turn to their families and the church.
The country has only one state psychiatric hospital, which is overcrowded, understaffed and resembles an asylum, according to Filipino-Americans working in the mental health field. Only patients with extreme cases, such as psychosis, are eligible for admission.
FOR THE RECORD - A photo caption accompanying an article in Sunday's editions about the suicides of two Filipino teachers misidentified the source of the photo. All photos of Irenea Apao were taken by Manny Lopez.
The Sun regrets the error.
The only other mental health care is at private facilities, not covered by insurance, and treatment is far beyond the financial means of most Filipinos.
"Those that are going to psychiatrists in the Philippines, first of all, they're rich people," said Jose Arturo "Art" Maga, a special education teacher at William S. Baer School. "The best thing is to have counsel with a priest, a pastor, without paying anything."
Officially, the Philippines has one of the lowest suicide rates in the world. But some say that suicide, considered a sin by the Catholic Church, often goes unreported.
"In the Philippines, they will make up other reasons for the official cause of death," said Annalisa V. Enrile, an assistant professor at the University of Southern California's School of Social Work. A Filipino herself, her research centers on the Filipino-American community.
Someone who has offered to help the teachers in Baltimore is Dr. Benedicto Borja, a Filipino who is associate director of the psychiatric residency training program at Sheppard Pratt and University of Maryland Medical Center. He previously headed the university medical center's psychiatric emergency services.
Borja and his wife, also a psychiatrist, moved to the United States in 1994 after medical school because there were virtually no opportunities to do a residency in psychiatry in the Philippines.
He was following in the footsteps of his father, who became a psychiatrist after watching two sisters struggle with mental illness. Both eventually committed suicide. But even then, Borja recalls that when one of his aunts died, his parents ordered him never to speak of the cause.
