The World Health Organization Assessment Instrument for Mental Health Systems
(WHO-AIMS) was used to collect information on the mental health system in Thailand.
The goal of collecting this information is to improve the mental health system and to
provide a baseline for monitoring the change. This will enable Thailand to develop
information-based mental health plans with clear base-line information and targets. It will
also be useful to monitor progress in implementing reform policies, providing community
services, and involving users, families and other stakeholders in mental health promotion,
prevention, care and rehabilitation.
Thailand has a mental health policy and plans. The legislation is still in the process and it
is likely to be ready soon. Approximately 3.5% percent of health care expenditures by the
government health department is directed towards mental health services and half of this
is devoted to the mental hospitals. In Thailand there are three different social insurances,
which provide free access to essential psychotropic medicines to 93% of the population.
A human rights review body exists, but it does not oversee regular inspections and has no
authority to impose sanctions
The Mental Health Department (MHD) is the national mental health authority. There are
122 outpatient facilities in the country, located in mental hospitals and in general
hospitals. Eleven percent of these facilities are for children and adolescents only. There
are no day treatment facilities in Thailand. The only residential facilities are for people
with mental retardation and substance abuse. There are 25 community-based psychiatric
units with 0.4 beds per 100,000 population and 17 mental hospitals with 13.8 beds per
100,000 population. The rate of users in community based inpatient units is 173 per
100,000 population and in mental hospitals is 158 per 100,000 population. The majority
of patients admitted to mental hospitals have a diagnosis of schizophrenia. All forensic
beds are located in one mental hospital for security reasons. It was estimated that most
admissions to mental hospitals and inpatient units are involuntary.
Mental health care has been integrated into primary health care by MHD for many years.
Primary health care doctors have limited training and interaction with mental health
services.
There are 7.29 personnel working in mental health for every 100,000 population. There
are few psychiatrists and psychosocial staff working in mental hospitals. In terms of staff
to bed ratios, there are 0.01 psychiatrists, 0.15 nurses, 0.02 psychologists, social workers
or occupational therapists and 0.05 other mental health workers per bed in mental
hospitals. Some professionals are working for both inpatient and outpatient facilities.
There is a disproportionate amount of resources concentrated in the main cities, which
limits access to mental health services for rural users. There are 5 user associations and 3
family associations present in the country interacting with a few mental health facilities.
Public education and awareness campaigns are overseen by coordinating bodies. There
are links between departments/agencies responsible for mental health and those
responsible for primary health care/community health, HIV/AIDS, reproductive health,
child/adolescent health, substance abuse, child protection, education, employment,
housing, welfare, criminal justice, and the elderly. There are legislative provisions for
employment, but not for housing. Only a few mental health facilities assist with
employment for people with severe mental disorders, through activities outside the
mental health facilities.
Data are collected by all the facilities and transmitted to the government. Each year a
report on this data is published. Only one percent of the health research from within the
country published in journals is on mental health.
Due to inherent limitations of this assessment, more time may be needed to improve the
quality of the data and to verify the consistency of the item definitions. The findings of
this assessment, as with any assessments, should therefore be interpreted with caution.