“Who Would Want a Broken Family?”: Stigma and Care-Seeking Among Women Experiencing Gender-Based Violence/Intimate Partner Violence and Suicidal Behaviors In the Philippines

Background and purpose: In the Philippines, gender-based violence (GBV), especially intimate partner violence (IPV), affects approximately one in four ever-married women (Philippine Statistics Authority, 2018). GBV/IPV is strongly associated with adverse mental health outcomes, including depression and suicidal behaviors among Filipino survivors (Aronoff et al., 2024; Alibudbud et al., 2024; Santos & De Guzman, 2025). Emerging evidence suggests high rates of suicide attempts among IPV survivors; however, less is known about how stigma, as a form of power operating across social, cultural, and institutional contexts, shapes survivors’ decisions to disclose violence and seek care for both IPV and mental health. Drawing on stigma theory (Bos et al., 2013; Link & Phelan, 2014), this study examines how multi-level stigma influences care-seeking among Filipina survivors of GBV with a history of suicidal behavior.

Methods: Participants (N=12) were adult women (ages 25 to 51; 4 married) with lived experiences of GBV and suicidal behaviors (not in acute crisis). Participants were recruited from a local non-government service provider in Cebu, serving survivors of GBV, IPV, and human trafficking. Participants attended one individual in-depth interview conducted in Cebuano, transcribed and translated into English for reflexive thematic analysis (Braun & Clarke, 2021). Research rigor was enhanced through reflective interview notes, post-interview debriefs, and regular consultations between interviewers and transcript analysts.

Results: Four themes illustrating how stigma operates across multiple levels to shape help-seeking were identified: (1) cultural mental health stigma positioned individuals experiencing GBV and suicidal behaviors as “crazy” and “weak,” discouraged disclosure; (2) family-centered stigma was reflected in the belief that “a toxic family is better than a broken family,” reinforcing pressure to remain in abusive relationships, particularly for children’s perceived well-being; (3) institutional stigma and discrimination emerged through negative interactions with police, government agencies, and service providers, eroding trust and reinforcing anticipated stigma; (4) internalized stigma and fear of judgement led participants to avoid disclosing GBV or suicidal thoughts to both formal and informal supports. Structural barriers, including the unavailability of divorce under Philippine law, further compounded these dynamics by limiting perceived and real options to separate from partners when desired. Together, these findings highlight how stigma is not only interpersonal, but structurally mediated/embedded, shaping both perceived and actual access to care.

Conclusions and implications: Findings underscore stigma as a multi-level, structurally-mediated barrier that constrains care-seeking among survivors navigating the intersection of GBV and mental health. GBV-focused interventions should move beyond individual-level stigma reduction to address institutional practices and structural barriers that reinforce vulnerability and marginalization. Trauma- and stigma-informed approaches should be integrated across mental health services, GBV response systems, and law enforcement. Engagement in community-based strategies that challenge norms prioritizing family preservation over safety is essential. Finally, legal reforms related to divorce and survivor protections are necessary for improving safety and engagement in care. Addressing stigma as not only an interpersonal issue, but a structural driver and determinant of health is central to improving survivor autonomy, engagement in care, and reducing the risk of adverse mental health outcomes among survivors in the Philippines.