HISTORY OF PSYCHIATRIC NURSING

The history of psychiatry and psychiatric nursing, although disjointed, can be traced back to
ancient philosophical thinkers. Marcus Tullius Cicero, in particular, was the first known person
to create a questionnaire for the mentally ill using biographical information to determine the
best course of psychological treatment and care. Some of the first known psychiatric care
centers were constructed in the Middle East during the 8th century. The medieval Muslim
physicians and their attendants relied on clinical observations for diagnosis and treatment.
In 13th century medieval Europe, psychiatric hospitals were built to house the mentally ill, but
there were not any nurses to care for them and treatment was rarely provided. These facilities
functioned more as a housing unit for the insane. Throughout the high point of Christianity in
Europe, hospitals for the mentally ill believed in using religious intervention. The insane were
partnered with “soul friends” to help them reconnect with society. Their primary concern was
befriending the melancholy and disturbed, forming intimate spiritual relationships. Today,
these soul friends are seen as the first modern psychiatric nurses.
In the colonial era of the United States, some settlers adapted community health nursing
practices. Individuals with mental defects that were deemed as dangerous were incarcerated
or kept in cages, maintained and paid fully by community attendants. Wealthier colonists kept
their insane relatives either in their attics or cellars and hired attendants, or nurses, to care for
them. In other communities, the mentally ill were sold at auctions as slave labor. Others were
forced to leave town. As the population in the colonies expanded, informal care for the
community failed and small institutions were established. In 1752 the first “lunatics ward” was
opened at the Pennsylvania Hospital which attempted to treat the mentally ill. Attendants
used the most modern treatments of the time: purging, bleeding, blistering, and shock
techniques. Overall, the attendants caring for the patients believed in treating the
institutionalized with respect. They believed if the patients were treated as reasonable people,
then they would act as such; if they gave them confidence, then patients would rarely abuse
it.
The 1790s saw the beginnings of moral treatment being introduced for people with mental
distress. The concept of a safe asylum, proposed by Philippe Pinel and William Tuke, offered
protection and care at institutions for patients who had been previously abused or
enslaved. In the United States, Dorothea Dix was instrumental in opening 32 state asylums to
provide quality care for the ill. Dix also was in charge of the Union Army Nurses during
the American Civil War, caring for both Union and Confederate soldiers. Although it was a
promising movement, attendants and nurses were often accused of abusing or neglecting the
residents and isolating them from their families.
The formal recognition of psychiatry as a modern and legitimate profession occurred in
1808. In Europe, one of the major advocates for mental health nursing to help psychiatrists
was Dr. William Ellis. He proposed giving the “keepers of the insane” better pay and training
so more respectable, intelligent people would be attracted to the profession. In his 1836
publication of Treatise on Insanity, he openly stated that an established nursing practice
calmed depressed patients and gave hope to the hopeless. However, psychiatric nursing was
not formalized in the United States until 1882 when Linda Richards opened Boston City
College. This was the first school specifically designed to train nurses in psychiatric care.
The discrepancy between the founding of psychiatry and the recognition of trained nurses in
the field is largely attributed to the attitudes in the 19th century which opposed training
women to work in the medical field.
In 1913 Johns Hopkins University was the first college of nursing in the United States to offer
psychiatric nursing as part of its general curriculum. The first psychiatric nursing
textbook, Nursing Mental Diseases by Harriet Bailey, was not published until 1920. It was not
until 1950 when the National League for Nursing required all nursing schools to include a
clinical experience in psychiatry to receive national accreditation. The first psychiatric nurses
faced difficult working conditions. Overcrowding, under-staffing and poor resources required
the continuance of custodial care. They were pressured by an increasing patient population
that rose dramatically by the end of the 19th century. As a result, labor organizations formed
to fight for better pay and fewer hours. Additionally, large asylums were founded to hold the
large number of mentally ill, including the famous Kings Park Psychiatric Center in Long
Island, New York. At its peak in the 1950s, the center housed more than 33,000 patients and
required its own power plant. Nurses were often called “attendants” to imply a more
humanitarian approach to care. During this time, attendants primarily kept the facilities clean
and maintained order among the patients. They also carried out orders from the physicians.
In 1963, President John F. Kennedy accelerated the trend towards deinstitutionalization with
the Community Mental Health Act. Also, since psychiatric drugs were becoming more
available allowing patients to live on their own and the asylums were too expensive,
institutions began shutting down. Nursing care thus became more intimate and holistic.
Expanded roles were also developed in the 1960s allowing nurses to provide outpatient
services such as counseling, psychotherapy, consultations, prescribing medications, along
with the diagnosis and treatment of mental illnesses.
The first developed standard of care was created by the psychiatric division of the American
Nurses Association (ANA) in 1973. This standard outlined the responsibilities and expected
quality of care of nurses.
In 1975, the government published a document called "Better Services for the Mentally Ill"
which reviewed the current standards of psychiatric nursing worldwide and laid out better
plans for the future of mental health nursing.
Global health care underwent huge expansions in the 1980s, this was due to the
governments reaction from the fast increasing demand on health care services. The
expansion was continued until the economic crisis of the 1970s.
In 1982, the Area Health Authorities was terminated.
In 1983, better structure of hospitals was implemented. General managers were introduced to
make decisions, thus creating a better system of operation. 1983 also saw a lot of staff cuts
which was heavily felt by all the mental health nurses. However a new training syllabus was
introduced in 1982, which offered suitable knowledgeable nurses.
The 2000s have seen major educational upgrades for nurses to specialise in mental health as
well as various financial opportunities.
 HISTORY OF PSYCHIATRIC NURSING IN THE PHILIPPINES

INTRODUCTION

The history of psychiatry in Phil., although relatively brief compared to the histories of
European and Western countries, is nonetheless colourful. The development of Philippine
psychiatry is punctuated and propelled by personalities, institutions and events.

The transitions in psychiatry can be gleaned through different historical periods: from the pre-
Spanish era, to almost 4 centuries of Spanish rule, followed by 4 decades under the American
regime, the brief but tumultuous Japanese occupation, up to the subsequent liberation by the
Americans.

PRE-SPANISH ERA

Prior to the Spanish period, there is a dearth of information on the incidence of mental illness,
as well as to the kind of treatment given, if at all.

It is surmised that each illness, whether of psychiatric nature or otherwise, was attributed to
inanimate objects or to natural and supernatural phenomena.

SPANISH PERIOD

Concepts on mental illness during the early Spanish period carried with it some of the pre-
Spanish concepts, as well as religious influences from our colonizers.
Mental illness or conditions effecting thought and behaviour were perceived to be caused by
supernatural forces such as:

 Angry deities whom the victims have displeased;

Witches or mangkukulam who cast by chanting incantations and pricking magic dolls; or by
Devilmen or mangagaway who could make their enemies mentally sick by praying to Satan.
* Delivered during the opening ceremonies of the 20th Annual convention of the Philippine
Psychiatric Association held last Jan 25, 1995 in Montebello hotel, Cebu City

The mentally ill wee either brought to churches for purification and exorcism, or to folk healers
or herbolaris who, in order to alleviate their patient's mental distress, subjected the victims
with physical stress. For example, as a means of driving the evil spirits away, the patient was
wrapped in mats and whipped with a bamboo stick or the tail of the stinger fish. Hot pots were
placed on top of their heads and they were made to drink bitter concoctions of herbs and tree
bark. There were times when the mentally ill was taken for a boat ride, only to the
unexpectedly thrown in the middle of the river. Surprisingly, this shocking experience often
produced favourable results in cases of hysteria, that is if the patient escaped drowning.

Unlike in other countries, there is no central figure in the evolution of Phil. Psychiatry. Thus,
we continue to trace the history of psychiatry during the Spanish era, through the
development of institutions for the mentally ill.

Documents reveal that the the institutional care and treatment of the mentally ill in the country
began at the start of 19th century at the Hospicio de San Jose.

Hospicio de San Jose was founded in 1782 to attend to the needs of the aged and the
orphaned, as well as serve as a place for recuperation for the patients of San Juan de Dios
Hospital. At around 1810, this institution assumed a new task of caring for the insane upon
the request of the Spanish Naval authorities for confinement of its mentally ill sailors.
Although there was one doctor among its staff, the Hospicio was ran by nuns and primarily
provided custodial care.

The Hospicio, then already located in a small island along the Pasig river in the San Miguel
district, was considered an idyllic place for the treatment and recuperation of the mentally ill
because of its isolation and fresh air. The wards of Hospicio were mainly natives and
Chinese, with a sprinkling of Spanish residents who cannot afford to return home.

Records of the Hospicio revealed a set of admission procedures for the mentally ill. To wit:

Complaints, usually involving disturbance of public peace were lodged by relatives or the
towns people, and subsequently, the Guardia Civil took custody of the mentally ill. The patient
is examined by a medico titular to ascertain mental illness, who in turn drafted a letter to the
governor general requesting admission of the patient to Hospicio. Once admitted, the doctor
of Hospicio again examines the patient.

Due to the limited number of staff and facilities at the Hospicio the Carcel de Bilibid had to
manage Hospicio's overflow, particularly those who were violent and have committed criminal
acts.

As to causation, documents showed that insanity or enagenacion mental, a term used to refer
to all forms of insanity or dementia, was due to person's inability to face reality or handle life's
pressure. Sisa, the tragic character in Rizal's Noli Me Tangere, illustrates this concept.

Insanity due to ana organic cause, although not clearly delineated from functional illness, was
already acknowledged during the late Spanish period. The term for an organic type of illness
was neurosis con trastornos mentales . This thinking was largely influenced by changes that
were happening in Europe.

AMERICAN REGIME

During the American regime, mental illness was perceived to be just like any disease and a
more humane approach towards the mentally ill was advocated. The change in orientation
reflected the transitions occurring in the United States regarding perceptions of mental illness.
In addition, there was an increase in the number of hospitals since health care was seen as
means of subjugation by the American colonizers.

Insane Dept. Of San Lazaro Hospital

This shift in orientation was marked by the establishment of the Insane Department of San
Lazaro Hospital in November 1904, under the newly created Bureau of Health. This was
considered the country's first hospital unit for the mentally ill.

During its first year operation, it had about 77 patients and with the increasing demand in
subsequent years, additional wards were constructed to accommodate 250 additional
patients, including those transferred from Hospicio de San Jose.

The First Filipino Psychiatrist

In 1917, dr. Elias Domingo ( a graduate of UP Class of 1913), then chief resident in Medicine,
was sent tp Pennsylvania, as Rockefeller scholar for two years to undertake training in
Psychiatry. Upon his return to the country, Dr. Domingo headed the Insane Department of
San Lazaro hospital. He is considered the first Filipino psychiatrist.

The City Sanitarium

By the year 1918, the City of Manila had already established its own mental hospital, the City
Sanitarium at San Juan del Monte under Dr. Telesforo Ejercito.
Thus, there were two institutions that cared for the mentally ill: the Insane Department, with
American and Filipino nurses providing psychiatric nursing care mostly for patients from the
provinces, and the City Sanitarium, later transferred to San Pedro Makati, to handle the
"insane of the city".

Despite the presence of institutions, there continued to be an unprecedented increase in the

mentally ill population. This may be attributed to many factors such as the increased
awareness for the need of institutional care and treatment for mental illness, as well as
increased incidence due to the socio-economic difficulties of the period.

As a means of addressing the increasing demand, several Filipino physicians were

successively sent to Harvard University in the early 1920's for training in psychiatry and
neurology. It should that majority, if not all of the existing psychiatric training programs were
combined with neurology. These physicians which included Dr. Jose a. Fernandez, Toribio
Joson, Leopoldo Pardo and Catalina Policarpio, later joined the staff of the Insane
Department upon their return.

National Psychopatic Hospital

In addition, the government decided to establish a hospital exclusively for the treatment of
patients with mental and nervous diseases. Substantial government appropriation allowed for
the purchase of 64 hectares of land in Barrio Mauway, Mandaluyong, Rizal, adjoining the
grounds of Welfare Village.

By December 18, 1928, around 400 patients of the Insane Dept. Were transferred to the new
hospital, marking the formal opening of the Insular Psychopathic Hospital. Dr. Elias Domingo
became the first chief of hospital, assisted by the nursing staff from San Lazaro.

The Insular or National Psychopathic Hospital was about 10 kms. from downtown Manila,
surrounded by farmlands, relatively secluded from the adjoining towns. When the City
Sanitarium closed in 1935, all its patients transferred to this hospital, further aggravating the
overcrowded state of its wards. In an effort to match the unabated increase in the number of
patients, additional pavilions were constructed thereby increasing its total bed capacity from
an initial 400, to 1,600 by the end of 1935.

The growth of medical institutions for training in psychiatry somehow paralleled the
development of hospitals for the mentally ill.

U.P COLLEGE OF MEDICINE

In the early 1900's the Civil Hospital was established at Calle Iris (now C.M. Recto) two
American physicians Dr. Donald Gregg and Dr. Charles B. May trained in medicine, managed
the mentally ill patients of the hospital. Around the same time, the Phil. Medical School, a
medical school patterned after the American training institutions was established.

By 1908, the University of the Phils. Have been established and the Philippine Medical
School became its College of Medicine. By 1910, the Phil. General Hospital was opened
alongside the school initially handling all patients transferred from civil Hospital. At that time,
Two American physicians Dr. Almond T. Gough and Dr. Samuel Tretze taught Psychiatry to
medical students and gave demonstrations at the Insane Dept. Of San Lazaro Hospital,
where the medical students briefly rotated. When the Psychopathic Hospital opened, the
students rotated for two weeks in this hospital.
Dr. Elias Domingo and the other U.S trained Filipino psychiatrists also lectured at the U.P.
college of Medicine.
UST

Although the Faculty of Medicine and surgery had already been established at the University
of Sto Tomas in 1871, psychiatry was not formally taught in its medical school. Its fourth year
medical school. Its fourth year medical students were given exposure to psychiatric patients
during their short rotation at the Insular Psychopathic Hospital.

Instruction in both these institutions was carried out in English, and American textbooks were
used.

Training at Psychopathic Hospital

Young staff members of the Psychopathic Hospital were sent for training as a means of
upgrading service delivery. In addition, Dr. Maximillian Silverman from Vienna was hired as
foreign consultant to the hospital.

Other Centers

Aside from the Insular Psychopathic Hospital, later called National Psychopathic Hospital,
psychiatric services were delivered at other centers. At the Sternberg General Hospital in
Manila, an American captain, a psychiatrist, attended to the neuropsychiatric cases of the U.S
Army.

At the Phil, Army General Hospital of Camp Murphy, Lt. Jaime Zaguirre, a young doctor with
inclinations to psychiatry, likewise provided treatment for Filipino soldiers.
Interestingly, empirical somatic therapies for the mentally ill were the most common modes of
treatment during the American regime. These included:

For manics

Fever therapy – inducing fever by protein injections, bite of malaria infected mosquitoes
Metrazol shock – inducing chemical shock by injection of camphor oil
Insulin shock – inducing hypoglycaemic coma
Lock's Sol for Schizophrenics (?)
Prolonged Narcosis
R1651 (Bromides) hyoscine injections
Hydrotherapy
For general paretics (brain syphilis, thought to be functional during that time)

Fever therapy
Tryparsamide
Neo-Salversamized serum-giving i.v. mercury preparations
For epileptics

Phenobarbital
Magnesium sulphate
Spinal drainage
Ketogenic diet
The depressed were also given Lock's sol, barbiturates and electroshock treatments.
Prior to World War II, psychotherapy sessions were generally not conducted. However,
adjunct therapies such as occupational and recreational therapies were already in vogue.

The Phil. Society of Psychiatry and Neurology

In 1935, the Phil. Society of Psychiatry and Neurology was organized with Dr. Jose
Fernandez as the elected president. The society released a monthly publication, the Journal
of Psychiatry and neurology, which documented local researches and discourse, as well as
the Society's activities.

THE JAPANESE OCCUPATION

The development of psychiatry in the country expectedly came to a standstill with the
outbreak of World War II on Dec. 1941. Majority of the patients were brought home by their
families; however, the Psychopathic Hospital managed to continue its operation under
Japanese rule.

Since some of its were used by the Japanese Imperial army in stockpiling their supplies, the
remaining patients were herded in small rooms and subsisted on limited food and medicines.
Electroconvulsive treatment became the principal therapeutic modality via an outmoded
Japanese apparatus, and local medicinal plants were made use of.

LIBERATION PERIOD

The large number of emotional casualties after the war led to an increased awareness and
appreciation of the importance of psychiatry.

As a consequence, the end of World War II was characterized by the rehabilitation and
expansion of psychiatric facilities as well as training of personnel. The National Psychopathic
hospital was renamed National Mental Hospital (NMH) in July 1946. Under the leadership of
Dr. Jose Fernandez, and with the help of donors, a building for pay patients was constructed,
as well as additional charity pavilions.

With the resurgence of psychiatric activities at NMH, other centers followed suit:

V. LUNA GENERAL HOSPITAL

The Neuropsychiatry service of the V. Luna General Hospital, a 100 bed unit in a general
hospital setting was established in 1946. Notable achievements include the performance of
the first pre-frontal lobotomy in the Phils. In 1947 by Major Romeo Gustillo, using his own
improvised leucotone. This successful operation was done on a violent schizophrenic who
failed to respond to ECT and other available therapies.

Two years later (Dec. 1949), the first transorbital lobotomy on a schizophrenic patient was
performed by Major Jaime Zaguirre, who received training in Australia.

UP COLLEGE OF MEDICINE

At the UP College of Medicine, Dr. Marciano Limson, then professor of anatomy and
neuroanatomy, took charge of teaching psychiatry in 1945. By 1950, Dr. Jorge Paras, A U. S
trained psychiatrist on Rockefeller scholarship, returned and taught psychiatry.

Dr. Carl Bowman, then Chairman of the Dept. Of Psychiatry at the University of California
Medical Center, made two brief visits to the college, under the sponsorship of the China
Medical Board of New York. His task was to appraise and assist in the development of the
undergraduate program in psychiatry. On Dr. Bowman recommendation, Dr. Baltazar V.
Reyes, Jr., then a resident in the Department of undergo training in psychiatry, also under the
sponsorship of the China Medical Board. Meanwhile, a succession of American psychiatrists
visited the country to further develop the undergraduate psychiatry program of UP.

When Dr. Baltazar Reyes returned in 1958, he headed the newly established Neuropsychiatry
section in the Department of Medicine. Three years later, Dr. Lourdes Vera Lapuz returned to
the country from psychiatric training from New York, and joined the Section.

By 1959, a three psychiatric residency training program was formally initiated, with Dr.
Benjamin Marte as its graduate. Other residents include Dr. Antonio Perlas, Cornelio Banaag
and Lourdes Ignacio.

In 1964, a separate unit, the Department of Psychiatry was established while Neurology
remained a section of the Dept. Of Medicine.

By 1982, the Division of child Psychiatry was established and fellowship training was started.

UST
At UST, the Section of Neurology and Psychiatry under the Department of Medicine was
organized in 1947, with Dr. Leopoldo Pardo as chief. It was considered a vestigial section,
with only four beds from the medical wards allotted to the section.

In 1950, the first privately-run institute of Neuropsychiatry was opened with a bed capacity of
thirty, primarily for the diagnosis and treatment of acute mental disorders. The institute's first
two resident physicians were sent to the Universidad Central de Madrid for specialized
training. Dr. Gilberto Gamez who was then teaching experimental psychology chose
psychiatry training, Dr. Gamez also completed a residency training in Neurology at the
Neurologic Institute of the Columbia-Presbyterian Medical Center.

Despite these achievements, the Institute of Neuropsychiatry was closed with a change in
rectorship of the university.

On March 1968, the section on Neurology and Psychiatry became a Department with Dr.
Gamez as its first chairman. The Dept. Was divided into two sections, and formal combined
residency training program in psychiatry and neurology was organized, with Dr. Leonor T.
Feliciano as its first graduate.

UERMMC

The increasing story emerged at UERM. In the mid-fifties (1956), a Dept. Of Psychiatry,
separate from Neurology and Medicine was established at the UERM hospital under the
chairmanship of Dr. Jaime Zaguirre. Dr. Zaguirre held this post till his retirement 20 years
later. After which, Psychiatry was merged with Neurology in 1977, under the newly created
Neuroclinical Services, only to regain its Department status in the late 1980s.

The Phil. Mental Health Association

The increasing mental health needs of the country and the overburdening of the local mental
institution spurred the organization of a private agency, the Philippine Mental Health
Association (PMHA). The association was founded in 1949 by Dr. Toribio Joson of NMH and
Dr. Manuel Arguelles. It aimed to promote the mental health activities in the country through
the provision of clinical services and public education.

In 1951, it pioneered a nationwide educational movement through the promotion of the first
National Mental Health Week, which later became an annual event. In the same year, the first
community mental health clinic in the country was initiated located in Cavite, later adding both
rural and urban based rehabilitation services.
In 1965, the PMHA funded the earliest known epidemiologic survey of mental disorders in the
country in Lubao, Pampanga which obtained a 36 per 1,000 population prevalence rate of
mental illness in the community.

The Phil. Society of Psychiatric and Neurology

The Phil. Society of Psychiatry and Neurology which was inactive during the war years,
resumed its activities in 1946, with Dr. Leopoldo Pardo as President.

Of the 167 registered members of the society in 1964, 11% have been certified by American
Boards, with another 10% eligible for the same. Only 20% practice Psychiatry as a sole
specialty because local conditions and attitudes limit the opportunities for psychiatric practice.

The Philippine Psychiatric Association

When the distinctions between Psychiatry and Neurology became clearer and separate
departments and training programs were established, the society's psychiatrists decided to
form a separate association. By 1972, the Philippine Psychiatric Association was organized
with Dr. Lourdes Ignacio as its founding president.

PSYCHIATRY FROM THE 70'S TO THE 90'S

The psychopharmacological revolution abroad ushered in the use of tranquilizers,

antidepressants and non-barbiturate sedatives in the country. More sophisticated drugs
followed after the newer discoveries regarding neurotransmitters. Thus, these events in the
70's to the 90's heralded the move towards more biological approach to psychiatric illness.

The last two decades also saw growth in the number of psychiatrists despite the rapid
increase in the number of teaching/training institutions. It was observed, that most the
psychiatrists were concentrated in Metro Manila and other urban centers of the country.

Psychiatry stagnated particularly in the 70's to the 80's, was characterized by government
neglect and public apathy towards mental illness.

The Aquino administration in the 1986, tried to address these problems by drumming up
multi-sectotal involvement and focusing on community-based interventions. The Task Force
on Mental Health, later named Project Team on Mental Health, was created by the Dept. Of
Health, composed mainly of psychiatrists. It aimed to formulate a new program on mental
health and recommend much needed organizational reforms. Its first initiative was the
reorganization of the National Mental Health, now given a new name, the National Center for
Mental Health, signifying its envisioned role as the country's repository of technical and
administrative expertise on mental health.

In 1989, the Project Team was instrumental in proposing 2 mental health bills in the
legislature that will give priority to community based mental health care activities, and create
a national coordinating body for mental health. It is unfortunate, that even after the Aquino
administration, these bills have not yet been promulgated.
 HISTORY OF CAGAYAN VALLEY MEDICAL CENTER

The Cagayan Valley Medical Center started from an army tent. Immediately after the war in
1945, the 37th Infantry put up the 43rd Filed Hospital that came from Pangasinan under Major
Anderson of the United State Marine Corps (USMC) treating both Filipino and American
soldiers. This is with the wholehearted cooperation of the late Dr. Venancio del Rosario. At
first, it was purely a military affair but they extended their services to civilians when they saw
the need of it as a result of the war diseases inflicted due to exposure, injuries, malnutrition,
etc.
Time came too early when the American-assisted Clinic stopped functioning. With the guts,
determination and resourcefulness of the first Cagayan Chief, the late Dr. Gregorio M. Reyes,
the defunct Philippine Civilian Auxiliary Unit was converted into Tuguegarao Hospital on June
25, 1945 having a 25-bed capacity. With this, they continued to use several USMC tents in
front of the Cagayan High School. In June 1945, when schools started to open its door to the
students and with the early start of the typhoon season, the hospital moved to the war-torn
residence of Mr. Pedro Atabug and James Whitney. Through donations, shows and dance
benefits, the Tuguegarao Hospital was able to pay the wages and salaries of its staff and
personnel.
At this point, the rehabilitation of the Tuguegarao Hospital was undertaken using nipa roof
and sawali walls. The hospital continued to solicit funds just so to survive with the ever-
helping funds of the late Secretary of Labor, Mr. Marcelo Adduru. On May 15, 1946, he was
able to transfer the Philippine Relief and Rehabilitation Administration (PRRA) three quonset
huts without cost to the said hospital for nurses’ dormitory, storeroom, dispensary and
doctor’s quarters.
In November 1945, through a Resolution of the Provincial Board under the administration of
the late Governor Baldomero Perez, the Tuguegarao Hospital was converted into Cagayan
Provincial Hospital and under the same leadership of the late Dr. Gregorio M. Reyes. He was
able to generate and set aside funds for the operation and maintenance of said hospital
through the help of the Provincial Board.

With funds coming from several sources, the hospital started to expand. The old nipa roofing
and the sawali walls started to deteriorate and the hospital was forced to moved to the
Division of Schools Building and at the same time, started the reconstruction of the two-storey
semi-permanent building, now being occupied by the present Integrated Provincial Health
Office (IPHO).
In 1947, the late Dr. Gregorio M. Reyes resigned and opened his private clinic and started his
private practice. Dr. Teogenes Alfonso took over on September 28, 1947. Dr. Justiniano M.
Mendoza was the next Chief and his administration was characterized by more improvements
and an intensive campaign to rural folks to use the hospital’s facilities, staff and employees.
Bed capacity was increased and the two-storey building was completed and inaugurated on
March 1, 1951. In August 1952, he went to the USA and studied as a scholar.
Several Chiefs took over. Amidst some limitations, the hospital continued to offer its services.
In July 1963, the Cagayan Provincial Hospital was designated as Regional Training and
Teaching Hospital per Department Administrative Order No. 79, s. 1963 which later was
classified as a Tertiary Regional Hospital for Region 02, per Ministry Administrative Order No.
83, s. 1980, dated April 22, 1980.
On July 20, 1983, the Regional Health Office Laboratory, Regional Mental Hospital and the
Cagayan Provincial Hospital were integrated and became the Integrated Cagayan Regional
Hospital.
In February 1986, this was transferred to its present site in Carig, Tuguegarao, Cagayan. A
bill was proposed to change its name to Cagayan Valley Regional Hospital but due to the
EDSA Revolution (People Power), such proposal died a natural death.
On September 15, 1989, it was finally changed to Cagayan Valley Regional Hospital (CVRH)
per RA No. 6782.
On March 20, 1998, it was converted to Cagayan Valley Medical Center (CVMC) under RA
No. 8599 with an authorized bed capacity of 500.