‘And meanwhile, in Thailand…’ – it feels like looking back into how mental health issues were dealt with 100+ years ago in Europe.

Thailand is very backward with respect to public information regarding mental illness and its treatment and training for mental health providers. The highest degree in psychology in Thailand is a bachelor degree, and psychotherapy in general is not been heard of, let alone being an integral part in modern health (or at least mental health) treatment.

What happens is that many people, especially in the countryside, are locked up or chained by their relatives or other people in their villages. They are called ‘baa’ (crazy) and are often considered as obsessed by ghosts or demons. Sometimes, the village head or ‘healers’ will involve some amateurish form of electro shock therapy which causes memory loss or more serious neurological damage. If mental patients are lucky and a medical doctor or even psychiatrist is in reach, treatment usually only consists of dropping pills, but there is no psychotherapy, no counseling, no social work.

And if all of that wasn’t enough, the well-hyped ’30 Baht [1 USD] healthcare scheme’ introduced by former PM Thaksin Shinawatra led to most of the better doctors leaving the (low-paid) countryside and now working in the highly paid private hospitals servicing foreigners.

Also, there is very little personnel trained in geriatric mental health care. With an aging population and growing numbers of patients afflicted with age related dementia, one may well call this a health care crisis.

Expats are in a somewhat better position, as they can afford to seek professional psychotherapeutic or counseling support from well-trained Westerners. Thai psychiatrists, even if Western-trained, are often sticking to medication as only means of treatment, and many of them also lack of understanding Western culture and mindsets.

“According to the Department of Mental Health’s survey, conducted 4 years ago, less than one percent or 400,000 Thais aged between 15-59 years are suffering from various type of psychotic disorders. The most common type of mental illness suffered by 70 percent of Thais with a mental disorder is Schizophrenia”

These numbers sound highly implausible and illustrate the very limited quality of mental health research (and consequently, treatment) in Thailand. Let us hope that the new focus of the Department of Mental Health to avoid maltreatment of mental health patients is only a first step of many necessary changes in policies and education of the public just as well as the professionals already working in the field.

More on the campaign (and image source): http://tannetwork.tv/tan/ViewData.aspx?DataID=1052726