วารสารสมาคมจิตแพทย์แห่งประเทศไทย
Journal of the Psychiatrist Association of Thailand
ISSN: 0125-6985
บรรณาธิการ มาโนช หล่อตระกูล
Editor: Manote Lotrakul, M.D.

Mental Health, Bangkok, Nov. 4-7, 1996.

** Somdet Chaopraya Hospital, Bangkok 10600

In 1996 the population is about 60 millions.

The history of modern psychiatry in Thailand began in 1889, when the first “Hospital for the Insane” was opened in Thonburi, now a suburb of Bangkok. The name of the hospital has been changed many times. It is now known as Somdet Chaopraya Hospital which is a psychiatric institute as well as a training center for psychiatric residents, psychiatric nurses, clinical psychologists and social workers.

The Department of Mental Health, Ministry of Public Health, is responsible for providing psychiatric care for the people all over the country, as well as mental health promotion, training of psychiatric and mental health personnel, and research.

At present the Department has 14 psychiatric hospitals or centers serving the whole country. Among these are one child psychiatric hospital, one child guidance center and two hospitals for the mentally retarded.

Psychiatric services in general hospitals are available in 39 government hospitals. Eight of them are in the medical colleges, under the administration of the Ministry of University Affair. Twenty-three are in the provincial hospitals of the Ministry of Public Health. Four of them are in the military hospitals, Ministry of Defence. Three of them belong to hospitals of the Bangkok Metropolitan Administration. There is also a psychiatric unit in the Police Hospital in Bangkok.

Psychiatric hospital statistics are shown in Table 1. Statistics of psychiatric units in general hospitals are shown in Table 2.

Psychiatric consultation services are available in most private hospitals in Bangkok and in big cities. Usually there is no specific ward for psychiatric patients, except in a few. There are also psychiatrists practicing in their private clinics serving psychiatric patients, mainly in Bangkok and big cities.

Many psychiatrists work full-time in government hospitals and part-time in private hospitals or private clinics.

The majority of psychiatric services are provided by the government sector, mainly in psychiatric hospitals or centers and in psychiatric units of general hospitals. The minority of people seek for psychiatric services in private hospitals or clinics.

There are two types of admission, the voluntary admission and the involuntary admission. When patients feel much distressed, they can come to the hospital for proper treatment and can be admitted whenever the psychiatrists find it appropriate.

Involuntary admissions usually take place in psychiatric hospitals when there is a risk that the patients’ symptoms are potentially harmful to themselves or to other people. The relatives of the patients are the ones who most commonly bring the patients to the hospitals. Since there is no “Commitment Law” in Thailand, involuntary admissions are usually possible by common agreements between psychiatrists and relatives of the patients. Sometimes patients are brought to the hospitals by the police.

In government hospitals, treatments are available free of charge to patients who have low income, elderly patients over 60 years of age, children under 12, and disabled persons. Others have to pay for meals, medications, laboratory investigations and rooms (option), ranging totally from a few hundred bahts to a few thousand bahts per day.

In private hospitals, patients are charged for rooms, meals, medications, laboratory investigations, service charges and doctors’ fees, starting from a minimum of a few thousand bahts per day.

The average duration of admission ranges from a few days in private hospitals to 1-2 months in psychiatric hospitals. The average length of stay at Somdet Chaopraya Hospital is 42 days.

Alcohol and drug dependency is an increasingly serious problem in Thailand as well as in other countries. The type of drug abuse is shifting from heroin, which is becoming more scarce and expensive, to amphetamine and its derivatives.

The country has recently passed a law for compulsory check of blood alcohol level among motor vehicle drivers to control accidents caused by drunken drivers.

The Department of Mental Health constantly launches campaigns and mental health education to the public, emphasizing the importance of family relationship and child rearing as preventive measures to minimize drug abuse among school children.

Treatment services for drug dependency are under the responsibility of the Department of Medical Services, Ministry of Public Health. Detoxification and rehabilitation programs are provided in Thanyarak Hospital and also in psychiatric units of many general hospitals all over the country. Some Buddhist temples as well as other Christian and non-governmental organizations have taken parts in the rehabilitation of drug-dependent patients.

There are two main organizations for psychiatrists in Thailand.

The Psychiatric Association of Thailand was founded in 1953. The qualification for applying for membership is training or working in psychiatry for at least one year, At present it has 310 members. It has been working as a private sector. The Journal of the Psychiatric Association of Thailand is its official journal published quarterly.

The College of Psychiatrists of Thailand was founded in 1991. It is legally attached to the Medical Council and has its function in the academic and ethical aspects. Since 1995 the College has been under the Royal Patronage and has become “The Royal College of Psychiatrists of Thailand”.

To become a member, one has to pass the board examination held annually by the Medical Council, after completion of the psychiatric training course of 3 years, and must also be approved by the Executive Committee of the Royal College. At present the Royal College of Psychiatrists of Thailand has 215 members.

Bibliographies

1. Statistics of the Department of Mental Health, Ministry of Public Health, 1995.

2. Statistics of departments of psychiatry of all medical colleges, 1995.

3. Statistics of departments of psychiatry of the military and police hospitals, 1995.

4. Statistics of departments of psychiatry of the Bangkok Metropolitan Administration

hospitals, 1995.

5. Statistics of departments of psychiatry of the provincial hospitals, Ministry of Public

Health, 1995.