World Health Organization

Mental health as the state of well being where a person can realize his or her own abilities to cope with normal stresses of life and work productively. This definition emphasizes that mental health is not just the absence of psychiatric disorder or illness but a positive state of mental health and mental disorders are not regarded with the same importance as physical health. Instead, they have been largely ignored and neglected.

Mental health problems have four facets as a public health burden. These are the defined burden, undefined burden, hidden burden and future burden.

Defined burden- burden currently affecting persons with ,mental disorders and is measured in terms of prevalence and other indicators such as the quality of life indicators and disability adjusted life years.( DALY)

Undefined burden
portion of the burden relating to the impact of mental health problems to person other than the individual directly affected. Repercussions of undefined burden are felt heavily by families and communities both in human and economic loss. Mental illness affects the person s functioning and thinking process, greatly diminishing a person s social role and productivity in the community.

Mental illness is disabling and lasts for many years. It puts a tremendous burden on the emotional and socio-economic capabilities of relatives who care for the patient, especially when the health system cannot offer treatment and support at an early stage.

Hidden burden
refers to stigma and violations of human rights. Stigma is a ,mark of shame, disgrace or disapproval that results in a person being shunned or rejected by others. The stigma associated with all forms of mental illness is strong but generally increase the more a person s behavior differs from that of the norm.

Future burden
Refers to the burden in the future resulting from the aging of the population, increasing social problems and unrest inherited from the existing burden.

World health organization report of 2003 showed that ,mental, neurological and substance use disorder cause a large burden of disease and disability: globally, 13% of overall disabilityadjusted life years (DALY s) and 33% of overall years lived with disability (YLD s).

More than 150M people suffer from depression at any point in time; nearly 1M commit suicide every year; and about 25M suffer from schizophrenia, 38M from epilepsy, and more than 90M from alcohol or drug use disorder.

A large portion of individuals do not receive any health care for this condition, firstly because the mental health infrastructure and service in the most countries are grossly insufficient for the large and growing needs

and secondly, because widely prevalent stigma and discrimination prevent them from seeking help. A policy for mental health care is lacking in 40% of the countries, and 25% of those with policy assign no budget to implement it.

Even where a budget east, it is very small: 36% of countries devote less than 1% of their health resources to mental health care. Though community- based services are recognized to be the most effective, 65% of all psychiatric beds are still in mental hospitals. (2003- WHO report)

In the Philippines, the most recent epidemiological data available on mental illness was the 1993-94 Baseline Survey conducted in Region VI. The survey showed in the total prevalence of mental illness among adults of 25.6% is as follows

: psychosis, 4.3%; depression, 5.3%; panic disorder, 5.5% and anxiety disorder, 10.5%. Among children, the results were broken down as follows: enuresis, 9.3%, speech and language disorder, 3.9%, mental abnormality, 3.7%; adaptation reaction, 2.4%; and neurologic disorder, 1.1%

MENTAL HEALTH SUBPROGRAMS

A.WELLNESS OF DAILY LIVING The process of attaining and maintaining mental well being across the life cycle through the promotion of healthy life style with emphasis on coping with psychosocial issues. Objectives To increase awareness among the population on mental health and psychosocial issues. To ensure access of preventive and promotive mental health services.

B EXTREME LIFE EXPERIENCES

An extreme life experience is one that is out of the ordinary and which threatens personal equilibrium. Objectives 1. To differentiate between critical incident and extreme life experiences 2. To identify situations which may be extreme life experiences 3. To categorize/ prioritize the extreme lofe experience which may be the concern of mental health

4. To identify programs that could address psychosocial consequences and mental health issues of persons with extreme life experiences. C. MENTAL DISORDERS Objectives Promotion of mental health and prevention of mental illness across the lifespan and across sectors (children and adolescents, adults, elderly and special population such as military, OFW s, refugees, persons with disabilities).

D. SUBSTANCE ABUSE AND OTHER FORMS OF ADDICTION Objectives 1. To provide implementers for advocacy accurate, technical information about psychosocial effects of drugs 2. To promote protective factors giants the developmet of substance abuse/addiction in the following key setting.(family, school, workplace, community health care setting, industry) through existing DOH programs and responsible agencies. 3. To rationalize and enhance the drug program to different key settings as a form of deterring factors.

The modern management for mentally ill patients is similar to other chronic diseases. Home care management is advocated. Acute cases are referred to the National Center for Mental Health (NCMH) or hospitals with psychiatric facilities for proper management. They are screened and after a few days they are assessed and discharged if they can be confined. A team from the ANtional Center for Mental Health follows up their discharged patients in the provinces.

NURSING RESPONSIBILITIES AND FUNCTIONS

1.

IN MENTAL HEALTH PROMOTION

Participate in the promotion of mental health among families and the community Utilize opportunities in his/her everyday contacts with other members of the community to extend the general knowledge on mental hygiene Help people in the community understand basic emotional needs and the factors that promote mental well being Teach parents the importance of providing emotional support to their children during critical periods in their lives as first day in school, graduation, etc.

2.IN PREVENTION CONTROL Recognize mental health hazard and street situation as unemployment, divorse or abandonment of children, vices, long standing physical illness, all of which may make heavy demands on the emotional resources of the persons concerned. Recognize pathological deviations from normal in terms of acting, thinking, and feeling and make early referral so that diagnosis and treatment could be done early. Be aware of the potential causes of breakdown and when necessary take some possible preventive action.

Help the family to understand and accept the patient s health status and behavior so that all members may offer as much support in the readjustment to home and community. Help patient assess his/her capabilities and his.her handicaps in working towards a solution of the problem. Encourage feeling of achievement by setting health goals that patient can attain Encourage the patient to express anxieties so that fears and misconception can be cleared up. Impart information and guidance about the treatment scheme of the patients, the desired and undesirable effects of the tranquilizers, psychiatric emergency management and other basic nursing care.

3. REHABILITATION Initiate patient participation in occupational activities best suited to patient capabilities, education, experience and training, capacities and interest. Encourage and initiate patients to partake in activities of CIVIC organization in the community through the cooperation of patient s family. Advise the family about the importance of regular follow up check up at the clinic. Make regular home visits to observe patients condition during conversation and follow up of medication.

IN RESEARCH AND EPIDEMIOLOGY

Participate actively in epidemiological survey to be aware of the size and extent of mental health problems of the community and organize a program for better preventive, curative and rehabilitative measures.

POINTERS FOR HAVING MENTAL HEALTH

Maintain good physical health Undergo medical examination or more often as needed Develop and maintain a wholesome lifestyle (balanced diet, adequate rest, exercise, sleep, recreation) Avoid smoking, substance abuse and excessive alcohol. Have a realistic goal in life Have a friend in whom you can confide and ventilate your problems

Don t lie in the past and avoid worrying at the future. Live one day at a time. Avoid excessive physical, mental and emotional stress. Develop and sustain solid spiritual values.