A HEALTH expert on Tuesday urged the government to expand telemedicine and psychosocial support services for Filipinos affected by conflict in the Middle East. The call follows a Department of Health (DOH) announcement that it would offer telemedicine services via the National Center for Mental Health (NCMH) crisis hotline to overseas Filipino workers (OFWs) in the region. In an interview with The Manila Times, Dr. Veronica Ramirez, a professor at the University of Asia and the Pacific, said that while the government response is already in place — such as through repatriation efforts — it is equally important to address mental health concerns beyond basic migrant welfare. She explained that many Filipinos trapped in conflict-affected areas are experiencing “a state of prolonged anticipatory fear.” “OFWs themselves experience daily exposure to repeated warnings, sirens, explosions, uncertainty, disrupted communication, and extreme fear for survival,” Ramirez said. “They have sharply elevated risks of depression, anxiety, and other trauma-related disorders.” She added that the uncertainty surrounding the conflict can make it difficult for workers to make rational decisions. “They have many questions in mind, such as, ‘Will our building be attacked next? Should I wait until the war is over, or should I go back to the Philippines now? Can my family still communicate with me?’” she said. Ramirez stressed that even if OFWs eventually return to the country, many may continue to carry psychological trauma. This, she said, highlights the importance of proactive measures to mitigate the long-term effects of armed conflict. According to the World Health Organization, one in five people in conflict settings will develop a mental health condition. Ramirez said the situation requires a broader crisis-response model rather than the standard hotline operation currently offered by the DOH. “The current conflict conditions demand a scaled crisis model rather than an ordinary hotline operation,” Ramirez said. “The following should be increased in the country of work: embassy-linked psychosocial desks, trained embassy personnel for psychosocial support, active outreach, field-linked psychosocial support, psychological first aid during evacuation, post-arrival counseling, and referral pathways for severe trauma cases.” However, Ramirez noted that a study she conducted during the Covid-19 pandemic found that help-seeking behavior tends to be weak during global crises. She said family members play an important role in improving this behavior. “Family members can help the OFWs who are in conflict-affected parts of the Middle East by saying consoling words in a calm voice during phone calls,” she said. She advised families to avoid statements that could heighten anxiety, such as repeatedly expressing fear or demanding that workers immediately return home. Ramirez also suggested the DOH expand its services by extending call durations for trauma-related consultations and clustering calls at the NCMH to better manage the volume of distress. “To elevate their assistance, NCMH can cluster their calls by hours [and] extend conversation hours because of complex trauma,” she said, noting that when connectivity is poor, families often panic and transfer their distress back to the worker. She added that telemedicine services could be temporarily expanded through the support of trained psychologists, guidance counselors, and volunteer psychiatrists. Aside from institutional support, Ramirez encouraged OFWs to adopt self-help strategies, such as maintaining regular meals, staying physically active, and limiting exposure to alarming news or conflict videos. She emphasized, however, that professional help should be sought immediately if individuals experience severe symptoms such as prolonged sleeplessness, panic attacks, confusion, or thoughts of self-harm.