Development of Community Mental Health Infrastructure in Thailand: From the Past to the COVID-19 Pandemic

Abstract

Thailand is an upper middle-income country located in the center of mainland Southeast Asia with a population of 66.17 million as of 2021. The aim of this review article is to illustrate the development of community mental health in our country. We have divided the article into five main sections: namely, the mental health service infrastructure, the community mental health system, human resources, mental health financing, public education, and links to other sectors. Mental health care has been integrated into primary care since 1982, resulting in a major shift in focus on mental health at the community level; however, mental health problems and the mental health gap in service accessibility remain present, especially during the current COVID-19 pandemic. Community mental health care has been extended to networks outside the health care system, including the community authorities. It has been provided with psychiatric care and rehabilitation, together with the promotion of mental health and prevention of mental disorders for improving accessibility to services, especially during a pandemic situation. Finally, future challenges to face community mental health have been outlined, such as insufficient staff to develop rehabilitation service facilities for people with chronic, serious mental illnesses; identifying supporting funding from other stakeholders; and mental health care for persons with long COVID living in the community.

Keywords

community mental health / COVID-19 pandemic / mental health service / rehabilitation / Thailand

References

[1] Community Mental Health: Thailand Country Report 2008 [Internet]. Department of Mental Health, Ministry of Public Health. [cited 2022Sep.22]. https://dmh.go.th/download/Ebooks/CommuMH2551/rptCommunity2008eng.pdf.

[2] Keyes JE. Thailand — Britannica [Internet]. Encyclopædia Britannica. [cited 2022Sep.22]. https://www.britannica.com/place/Thailand.

[3] Thailand in Brief. Demographic. [Internet]. Thailand Board of Investments. [cited 2022Sep.22]. https://www.boi.go.th/index.php?page=demographic.

[4] The Bureau of Registration Administration. The announcement of the Central Registration Office: Number of population in the Kingdom of Thailand. [Internet]. Bangkok: Department of Provincial Administration; 2022. [cited 2022Sep.22]. http://www.ratchakitcha.soc.go.th/DATA/PDF/2565/E/012/T_0010.PDF.

[5] The World Bank in Thailand: Overview. [Internet]. The World Bank. [cited 2022Sep.22]. https://www.worldbank.org/en/country/thailand/overview#1.

[6] Thanaudom K, Jampathong N, Udomratn P. One hundred and thirty years of psychiatric care in Thailand: Past, present, and future. Taiwanese J Psychiatry (Taipei). 2018 Jan;32(1):9–17.

[7] Prevalence of mental disorders and mental health problems: Results of the Thai National Mental Health Survey 2013. [Internet]. Nonthaburi (Thailand): Department of Mental Health. [cited 2022Sep.22]. https://dmh.go.th/ebook/files/prevalence_of_M_disorder_MH_problems_TNMHS2013.pdf.

[8] Institutional Repository for Information Sharing. World Health Organization assessment instrument for mental health systems, WHO-AIMS version 2. January 1, 2005. [Internet]. World Health Organization. [cited 2022Sep.22]. https://apps.who.int/iris/handle/10665/70771.

[9] Kwansanit P, Srisurapanont M. The parameters for calculating the burden of schizophrenia in Thailand. J Mental Health Thailand. 2018;26(1):50–62.

[10] Kittitharaphan W, Wattanasuksa P. Years lived with disability from autism spectrum disorders in Thailand. J Mental Health Thailand. 2018;26(1):16–26.

[11] Panyawong W, Santitadakul R, Pavasuthipaisit C. Prevalence of depression and suicidal risks in Thai adolescents: a survey in schools from 13 Public Health Region. J Mental Health Thailand. 2020;28(2):136–149.

[12] Visanuyothin T, Pavasuthipaisit C, Wachiradilok P, Arunruang P, Buranasuksakul T. The prevalence of attention deficit/hyperactivity disorder in Thailand. J Mental Health Thailand. 2013;21(2):66–75.

[13] National suicide prevention center. Report on Thailand’s suicide rate. [Internet]. KhonKaen (Thailand): KhonKaen Rajanagarindra Psychiatric Hospital. [cited 2022Sep.22]. https://suicide.dmh.go.th/report/suicide/stat_prov.asp.

[14] Department of Mental Health. Mental Health Check In DASHBOARDS. [Internet]. Nonthaburi (Thailand): Department of Mental Health. [cited 2022Sep.22]. https://checkin.dmh.go.th/dashboards.

[15] WHO-AIMS REPORT ON MENTAL HEALTH SYSTEM IN THAILAND [Internet]. World Health Organization. 2006 [cited 2022Sep.22]. https://cdn.who.int/media/docs/default-source/mental-health/who-aims-country-reports/thailand_who_aims_report.pdf?sfvrsn=853b6294_3&download=true.

[16] The ASEAN Secretariat. ASEAN mental health systems. [Internet]. ASEAN Secretariat. 2016 [cited 2022Sep.22]. https://asean.org/wp-content/uploads/2017/02/55.-December-2016-ASEAN-Mental-Health-System.pdf.

[17] Department of Mental Health. Stucture of the Department of Mental Health. [Internet]. Nonthaburi (Thailand): Department of Mental Health. 2016 [cited 2022Sep.22]. https://dmh.go.th/intranet/structure/chart02/.

[18] Mental Health Atlas 2020 Country Profile: Thailand. January 1, 2020. [Internet]. World Health Organization. 2022 [cited 2022Sep.22]. https://cdn.who.int/media/docs/default-source/mental-health/mental-health-atlas-2020-country-profiles/mental-health-atlas-tha-2020-country-profile.pdf?sfvrsn=41911214_1&download=true.

[19] Department of Mental Health. Annual report 2021 [Internet]. Bangkok: Ministry of Public Health; [cited 2022Sep.22] https://dmh.go.th/ebook/files/รายงานประจำปีกรมสุขภาพจิต%20ปีงบประมาณ%202564.pdf.

[20] Office of the Counsil of State. Mental Health Act, B.E. 2551. February 13, 2008. [Internet]. Bangkok (Thailand): Office of the Council of State. 2008 [cited 2022Sep.22]. http://web.krisdika.go.th/data/document/ext810/810000_0001.pdf.

[21] Mental Health Strategy and Planning Division, Department of Mental Health. The Mental Health Act. July, 2019. [Internet]. Nonthaburi (Thailand): Department of Mental Health. 2019 [cited 2022Sep.22]. https://necam.go.th/wp-content/uploads/2020/11/02รวมกฎหมาย-พรบ.สุขภาพจิต-พ.ศ.2551-และที่แก้ไขเพิ่มเติม-ฉบับที่-2-พ.ศ.-2562-1.pdf.

[22] Thailand’s National Mental Health Plan B.E. 2561-2580. Department of Mental Health. [Internet]. Nonthaburi (Thailand): Department of Mental Health; 2019 [cited 2022Sep.22]. https://www.dmh-elibrary.org/files/original/3a3fce5f017f6d4b9ecad0b22d820658.pdf.

[23] The Ministry of Public Health. Health resources/psychiatrist. [Internet]. Nonthaburi (Thailand): The Ministry of Public Health. 2022 [cited 2022Sep.22]. http://gishealth.moph.go.th/healthmap/resdetail.php?st=2&nd=15&rd=15&l1=7&l2=&l3=&ft=1&t=4.

[24] Department of Mental Health. Manual of care service system for patients with serious mental illness at high risk for violence. June 1, 2020. [Internet]. Nonthaburi (Thailand): Department of Mental Health. 2020 [cited 2022Sep.22]. http://www.mhso.dmh.go.th/fileupload/202010061612167390.pdf.

[25] Arunpongpaisal S, Kongsuk T, Maneethorn N, Maneethorn B, Wannasawek K, Leejongpermpoon J, Kenbupa K, Budwong S. Development and validity of two-question screening test for depressive disorders in Northeastern Thai community. Asian J Psychiatr. 2009 Dec;2(4):149–52. doi: 10.1016/j.ajp.2009.10.002. PMID: 23051095.

[26] Kongsuk T, Arunpongpaisal S, Loiha S, Maneeton N, Wannasewok K, Leejongpermpoon J, Kenbubpha K. Development and validity of 9 questions for assessment of depressive symptom in Thai I-san community. Presented at: 6th International Workshop on Mental Health and Well-being: Sensing and Intervention. 2007. [Internet]. Researchgate. 2008. https://www.researchgate.net/publication/291800462_The_development_and_validity_of_9_questions_diagnostic_test_for_depressive_disorders_in_Thai_I-san_community.

[27] Kongsuk T, Supanya S, Kenbubpha K, Phimtra S, Sukhawaha S, Leejongpermpoon J. Services for depression and suicide in Thailand. WHO South East Asia J Public Health. 2017 Apr;6(1):34–38. doi: 10.4103/2224-3151.206162. PMID: 28597857.

[28] Sirithongthaworn S. The development of the Developmental Surveillance and Promotion Manual; DSPM. J Psychiatric Association Thailand. 2018;63(1):3–12.

[29] Child and Adolescent Mental Health Rajanagarindra Institute (CAMRI). School Health HERO Project. [Internet]. Child and Adolescent Mental Health Rajanagarindra Institute. 2016 [cited 2022Sep.22]. https://new.camri.go.th/เครือข่าย-ฐานข้อมูล/School-Help-HERO.

[30] Department of Mental Health. Mental Health Check In DASHBOARDS. [Internet]. Non-thaburi (Thailand): Department of Mental Health. 2022 [cited 2022Sep.22]. https://checkin.dmh.go.th/dashboards/dash04.

[31] The Ministry of Public Health. Health resources. [Internet]. Nonthaburi (Thailand): The Ministry of Public Health. 2022 [cited 2022Sep.22]. http://gishealth.moph.go.th/healthmap/index.php?region=00&level1=2&level2=15&submit=แสดงข้อมูล.

[32] The Medical Council of Thailand. Statistics of specialized physicians during 1964–2021. December 7, 2021. [Internet]. The Medical Council of Thailand. 2021 [cited 2022Sep.22]. https://www.tmc.or.th/pdf/stat-med-2021-004.pdf.

[33] The Ministry of Public Health. Number of healthcare personnel/psychiatrist. [Internet]. Nonthaburi (Thailand): The Ministry of Public Health. 2022 [cited 2022Sep.22]. http://gishealth.moph.go.th/healthmap/resource.php.

[34] The Ministry of Public Health. Healthmap/charts. [Internet]. Nonthaburi (Thailand): The Ministry of Public Health. 2022 [cited 2022Sep.22]. http://gishealth.moph.go.th/healthmap/chartst.php.

[35] The Occupational Therapist Association of Thailand. Service database. [Internet]. Chiangmai (Thailand): The Occupational Therapist Association of Thailand. 2022 [cited 2022Sep.22]. https://www.otatthai.com/17535477/ฐานข้อมูลบริการ.

[36] The National Health Security Office. NHSO Annual Report 2021. [Internet]. Bangkok (Thailand): The National Health Security Office. 2021 [cited 2022Sep.22]. https://eng.nhso.go.th/view/1/Annual_Reports/EN-US.

[37] Badenoch JB, Rengasamy ER, Watson C, Jansen K, Chakraborty S, Sundaram RD, Hafeez D, Burchill E, Saini A, Thomas L, Cross B, Hunt CK, Conti I, Ralovska S, Hussain Z, Butler M, Pollak TA, Koychev I, Michael BD, Holling H, Nicholson TR, Rogers JP, Rooney AG. Persistent neuropsychiatric symptoms after COVID-19: a systematic review and meta-analysis. Brain Commun. 2021 Dec 17;4(1):fcab297. doi: 10.1093/braincomms/fcab297. PMID: 35169700; PMCID: PMC8833580.

RIGHTS & PERMISSIONS

Wannasewok K., Suraaroonsamrit B., Jeungsiragulwit D., Udomratn P.