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PSYCHIATRIC NURSING

TERTIARY LEVEL OF PREVENTION

RLE 3.2.3
Clemeno, Kristopher Klein I.
Co, Allison Jasper I.
Contreras, Vanessa Joy M.
Cortez, Augustine Beth D.
Corullo, Kim Philby G.
Costo, Kristine Mae C.
Cruz, Andrea J.
Cruz, Kate Angeli
Cruz, Marien Edel F.
Cruz, Prince Raymond
Cu, Trisha Gail C.

Tertiary Level of Prevention


Tertiary prevention seeks to soften the impact caused by the disease on the patients function,
longevity, and quality of life. Examples include cardiac rehabilitation following a myocardial infarction,
seeking to alter behaviours to reduce the likelihood of a reinfaction. Tertiary prevention can include
modifying risk factors, such as assisting a cardiac patient to lose weight, or making environmental
modifications to reduce an asthmatic patients exposure to allergens.
Tertiary Prevention strategies involve both therapeutic and rehabilitative measures once disease is
firmly established. Examples include treatment of diabetics to prevent complication of the disease and the
ongoing management of chronic heart disease patients with medication, diet, exercise, and periodic
examination. Other examples include improving functioning of stroke patients through rehabilitation by
occupational and physical therapy, nursing care, speech therapy, counseling, and so forth, and treating
those suffering from complications of diseases such as meningitis, multiple sclerosis, or Parkinsons
disease.
On community level, providing high quality, appropriate, and accessible health care and public
health resources is critical to assuring satisfactory primary, secondary, and tertiary prevention. Table 3-1
summarizes the three levels of prevention and provides examples of their applications at the community
level.
When the condition is not reversible, tertiary prevention focuses on rehabilitation, assisting the
patient to accommodate to his disability. For reversible conditions, such as many types of heart disease,
tertiary prevention will reduce the population prevalence, whereas for incurable conditions it may
increase prevalence if it prolongs survival. The key goal for tertiary prevention is to enhance quality of
life.
Philippine Mental Health Programs on Tertiary Level Prevention
The National Mental Health Program (NMHP) now, under the Degenerative Disease Office of the
National Center for Disease Prevention and Control (NCDPC), Department of Health. It aims at
integrating mental health within the total health system, initially within the DOH system, and the local
health system. Within the DOH, it has initiated and sustained the integration process within the hospital
and public health systems, both at the central and regional level. Furthermore, it aims at ensuring equity
in the availability, accessibility, appropriateness and affordability of mental health and psychiatric
services in the country.
Vision
Full integration of Mental Health in the national system
Mission

To make available, accessible, affordable and equitable quality mental health care/services to the Filipinos
especially the poor, the underserved and high risk populations.
Mandate
To provide the Department of Health with necessary services related to planning, programmming and
project development in mental health.
Functions
1. Advisory body to the Secretary of Health regarding mental health concerns.
2. Acts as a policy making body regarding mental health concerns
3. Involves itself in training, research, supervision and, monitoring of mental health
resources/programs services.
4. Mobilizes mental health resources for advocacy, planning, implementation and service delivery.
Guiding Principles

Mental health is not only limited to traditional mental illnesses but also includes the psychosocial
concomitants of daily living.
Mental health programs must recognize the importance of community efforts with multisectoral
and multidisciplinary involvement.
Mental health programs must address the promotive,preventive, curative and rehabilitative
aspects of care.
Psychiatric patient care extends beyond the mental hospitals, and must be made available in
general hospitals, health centers and homes.
Mental health activities and interventions must be done closest to where the need or the patient is.

Strategies

National diffusion and democratization of capabilities of mental health facilities.


Intensification and strengthening the training in psychiatry and mental health.
Peripheral development
Development of clinical policies
Institution building
Focus on research
Advocacy
Networking

Priority Areas of Concern

Substance abuse
Disaster and crisis management
Women and children and other vulnerable groups
Traditional mental illnesses (schizophrenia, depression and anxiety)
Epilepsy and other neurological disorders
Overseas Filipino workers

Some programs enacted by the NMPH are as follows: (1) the demonstration project which
involves the development of a collaborating center for mental health. The aim of which is to shift mental
health care out of the hospitals to a variety of community-based services ranging in primary health care.
(2) they have also sustained the Lusug Isip program and considers this its flagship program because the
Department of Health has integrated it into some of its programs. The program is an annual advocacy and
mental health promotion program directed at mental health concerns. It uses a life course approach.

Youth Life Enrichment Program (YLEP)/ Youth Life Skills Program aims to train the youth
to become crusaders of mental health, by helping them become aware of themselves, their
environment and social issues pertinent to mental health. It provides leadership trainings,
seminars on interpersonal relationships among adolescents, and other opportunities for
personality development & enrichment for the youth. It comprisesof the LusogIsipngKabataan
(LINK) Club, a mental health club for high school students since 1975; and the Psychological
Societies Association on Mental Health (PSAMH)/ Progressive Youth Association on Mental
Health (PYAMH), a mental health club for college students.

Mental Health Community-Based Program (MHCBP)/ Mental Health Community


Outreach Program (MHCOP) promotes mental health programs at the grass roots level by
providing lecture-forums & trainings and by organizing &training a core group of barangay
health workers who will help PMHA in the implementation of its mental health projects in the
communities.

The (Rehabilitative Service) RS operates an out-patient center, which provides day care services
and vocational activities as well as psychosocial therapeutic activities for persons with mental
disabilities and their families. In addition, it has extended its service to out-of-school youth and
unemployed adults in the EISs Mental Health Community-based Program.

International Rehabilitation Council for Torture Victims (IRCT) puts the spotlight on a
critical yet neglected area within the fight against impunity and rehabilitation itself. The positive
effects of psychosocial support to victims of torture in legal proceedings and to the fight against
impunity cannot be ignored," said Victor Madrigal-Borloz, IRCT Secretary-General.

Health and Wellness Program of Persons with Disabilities focuses on 1) removal of barriers
and improve access to health services and programs; (2) strengthening and expansion of
rehabilitation, habilitation, assistive technology, and community-based rehabilitation; (3)
strengthen collection of relevant and internationally comparable data on disability and support
research on disability and related services.

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159166. Retrieved last January 19, 2015 from
http://www.hawaii.edu/hivandaids/Philippines_Mental_Health_Country_Profile.pdf
World Health Organization & Department of Health (2006). WHO-AIMS Report on Mental Health
System in The Philippines. Retrieved last January 19, 2015 from
http://www.who.int/mental_health/evidence/philippines_who_aims_report.pdf
(2014). Human Rights Day 2014: Psychosocial Support in Focus. http://www.balayph.net/news/92human-rights-day-2014-psychosocial-support-in-focus-with-launch-of-report.html
Australian Government Department of Health (2014).Mental health programs. Retrieved last January 19,
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Cuevas, MF. (2014). Persons with disabilities. First Public Health Convention on the Health and Wellness
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