Legazpi City Bicol University-Mabini Colleges: In Partial Fulfillment of Requirements in SubjectMAN 213: TRENDS, ISSUES & PROBLEMS IN COMMUNITY HEALTH NURSINGProf. Paul C. Abao Jeanny J. Abawag, RNMAN Student

MENTAL HEALTH AND MENTAL DISORDERSWHO - defines mental health as a state of well-being where a person can realize his/her own abilities to cope with normal stresses of life and work productively.

4 FACES OF MENTAL HEALTH1. DEFINED BURDEN-Is the burden CURRENTLY affecting person with mental disorders and is measured in terms of prevalence and other indicators.The quality of life indicatorsDisability Adjusted Life Years (DALY)2. UNDEFINED BURDENIs the portion of the burden relating to the impact of mental health problems to persons other than the individual directly affected.Repercussions of undefined burden are felt heavily by the families and communities both in human and economic loss3. HIDDEN BURDENRefers to the STIGMA and VIOLATIONS of HUMAN RIGHTS.STIGMA- a mark of shame, disgrace or disapproval that results in a person being shunned or rejected by others.4. FUTURE BURDENThe burden in the future resulting from aging of the population, increasing social problems and unrest inherited from the existing burden.The World Health Report of 2003 showed that mental, neurological and substance use disorders cause a large burden of disease and disability: globally,13% of overall DALY,33% of overall years lived with disability (YLDs). More than 150M people suffer from depression at any point in time; nearly 1million commit SUICIDE every year and about 25 million suffer from SCHISOPHRENIA, 38M from EPILEPSY, and more than 90M from ALCOHOL or DRUG USE disorder.A policy for mental health care is lacking in 40% of countries and 25% of those with a policy assign no budget to implement it. Even when a budget exists, it is very small: 36% of countries devote less than 2% of their total 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 epidemiologic data available on mental illness was the 1993-1994 Baseline Survey conducted in Region VI. The survey showed the total prevalence of mental illness

ADULTS of 25.6% Psychosis- 4.3%Depression- 5.3%Panic Disorder- 5.5%Anxiety Disorder- 10.5%

CHILDRENEnuresis- 9.3%Speech and Language Disorder-3.9%Mental Subnormality-3.7%Adaptation Reaction- 2.4%Neurotic Disorder- 1.1%

The current bed capacity for mental disorders is 5,465. Of these, 4,200 beds are in the NCR (at the National Center for Mental Health). The rest of the country shares the remaining 1,265 beds. Regions 1, 4. 10,12 CARAGA and ARMM do not have inpatient psychiatric facilities. Only 27 DOH medical centers and regional hospitals have mental health services. Cavite is the province with a psychiatric facility.MENTAL HEALTHS SUB-PROGRAMSA. Wellness of Daily LivingThe process of attaining and maintaining mental-well being across the lifecycle through the promotion of healthy lifestyle with emphasis on coping with psychosocial issues.OBJECTIVES1. To increase awareness among the population on mental health and psychosocial issues.2. To ensure access of preventive and promotive mental health services.B. EXTREME LIFE EXPERIENCESAn extreme life experience is one that is out of the ordinary and which threatens personal equilibrium.OBJECTIVES1. To differentiate between critical incident and extreme life experiences2. To identify situations which may be extreme life experiences3. To categorize or prioritize the extreme life experience which may be the concern of mental health4. To identify the programs that address psychosocial consequences and mental health issues of persons with extreme life experiences.

C. MENTAL DISORDEROBJECTIVESPromotion of mental health and prevention of mental illness across the lifespan and across sectors (children and adolescents, adult, elderly, and special population such as military, OFWs, refugees, PWDs).

D. SUBSTANCE ABUSE AND OTHER FORMS OF ADDICTIONOBJECTIVES1. To provide implementers for advocacy accurate, technical information about the psychosocial effects of drugs.2. To promote protective factors against the development of substance abuse/addiction in the following key settings (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 factor.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 Health Center for Mental Health (NCMH) or hospitals with psychiatric facilities for proper management. They are screened and after a fe days they are assessed and discharged if they can be manage at home. Cases needing continuing supervision and care may be confined. A team from the NCMH follows up their discharged patients in the provinces.NURSING RESPONSIBILITIES AND FUNCTIONS1. 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 at first day in school, graduation etc.2. IN PREVENTION AND CONTROL Recognize mental health hazards and stress situations as unemployment, divorce or abandonment of children, vices, long standing physical illness. 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 patients health status and behavior. Help patient assess his/her capacities and his/her handicaps in working towards s solution on his/her problem. Encourage feeling of achievement by setting health goals that patient can attain. Encourage the patient to express his/her anxieties. Impart information and guidance about the treatment scheme of the patients, the desired and undesirable effect of the tranquilizers, psychiatric emergency management and other basic nursing care.3. REHABILITATION Initiate patient participation in occupational activities best suited to the patients 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 patients family. Advise the family about the importance of regular follow-up at the clinic. Make regular home visits to observe patients conditions during conversation and follow-up of medication.4. IN RTESEARCH AND EPIDEMIOLOGY Participate in the 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 annual medical examination or more often as needed Develop and maintain a wholesome lifestyle (balanced diet, adeq, rest exercise, sleep and 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 Dont live in the past and avoid worrying about the future Live-one day at a time Avoid excessive physical, mental and emotional stress. Develop and sustain solid spiritual values.