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Parliament’s historic step: Mental health challenges and budget priorities in Thailand

Written by World Events

History was made in December when psychiatric issues were, for the first time, officially discussed in parliament, raising interest among the Thai people.

Sasima Phaibool, 38, who has bipolar disorder, said “I’m glad an MP raised psychiatric issues in parliament. It gives me hope that there’s someone advocating for us, making people more interested and aware of mental illness.”

“I’m glad someone with firsthand experience spoke about the issue, making those in power acknowledge it,” said Peerapong Sahawongcharoen, 54, who lives with schizophrenia.

During a House of Representatives meeting to consider the draft Budget Expenditure Act for Fiscal Year 2024, Move Forward MP Sirilapas Kongtrakarn revealed her experience with depression, standing up for those with mental illnesses and highlighting crucial issues.

File photo: Move Forward MP Sirilapas Kongtrakarn

She pointed out that the budget gives more weight to those using drugs than to those with mental illnesses, addressing the rise in mental health problems, the shortage of medical personnel and inadequate treatment coverage in parliament.

“The budget allocation should be fair and reasonable. I want the government to take psychiatric issues seriously,” said Sasima, adding that our country needs to prioritise mental health, as some still don’t understand what well-being is.

Peerapong also hopes the government allocates a reasonable budget for psychiatric issues, ensuring comprehensive services for people with mental illnesses can enjoy an acceptable quality of life.

In an interview with Thai PBS World, Dr. Supasaek Virojanapa, a Preventive Medicine (Community Mental Health) Physician, explained that, according to World Health Organisation (WHO), mental health problems and suicide rates haven’t been increasing, but awareness has. The acceptance in society makes more people comfortable revealing themselves, especially within the medical treatment system. During the most serious period of the COVID-19 pandemic, however, the suicide rate did increase.

Dr. Supasaek pointed out that the number of psychiatrists is not low, compared to other mid-high income countries. Nonetheless, based on vocational standards, it’s quite low. Doctors can’t spend adequate time with each patient, due to the high number of patients, with only 5 minutes being spent with each patient, instead of the recommended 30 minutes. This inefficiency could lead to burnout. Additionally, the waiting list to see a doctor is so long, taking 3-4 months for a new patient.

“Eight years ago, when I took my sister to a government psychiatric hospital for the first time, the queue was so long,” explained Phraewphan Noptrakul, 50, a caregiver. “It took 2 hours for basic checks and another 4 hours to see the doctor. So, the next time, we went to the hospital at 5:45am to get in the queue early.”

She added that, even in the city, access to treatment is challenging. She empathises with those in rural areas who hardly have access to services, and, if they do, there’s a travel cost. For those with low incomes, accessing treatment is financially challenging.

Dr. Supasaek mentioned that “It’s a positive sign that the last government allocated 800 million baht to produce more psychiatrists, but it takes around 10 years to see results.”

Sasima emphasised that “There should be psychotherapists in every hospital and social workers and child psychologists in schools.”

The doctor also highlighted that the salaries of public sector psychiatric medical personnel are relatively low, compared to private hospitals. This prompts them to leave public hospitals for private ones. Raising their salaries could encourage more doctors to work in public hospitals, making services, medicines and personnel more efficient and benefiting the economy.

Darundorn, 34, living with schizophrenia, suggested the government should improve the “brand image” of the psychiatric profession by raising salaries.

Talking about pharmaceutical issues, Dr. Supasaek mentioned that many effective medicines are not in the National List of Essential Drugs, affecting treatment quality and leading to chronic illness.

Phraewphan shared that, once her sister was prescribed medicine causing side effects. It made her look skywards all the time.

Dr. Supasaek suggested that putting effective medicines on the list could improve treatment. The government should support studies on including the most worthwhile medicines on the list.

He also added that the government should invest in the system, adopting AI to leverage the work of personnel like psychotherapists or psychiatrists.

Darundorn, however, suggested the government should address the root causes, adding “Everything begins with the mindset, values and perceptions. If they are right, everything is right.”

“Marketing or propaganda should be used to raise awareness of mental illness, done through media or influencers, and people should be educated, starting at school, among the family and in the workplace.”

He also said that, these days, people still think people with depression are weak or have “negative thinking”. In fact, depression is caused by an imbalance of chemicals in the brain.

“The government should campaign, to raise awareness of mental illness. If people are educated and have the right understanding, stigma and discrimination will decrease,” suggested Peerapong.

Darundorn agrees that mental illness affects the national economy, as people with such illnesses cannot work. The country not only incurs expense but also loses tax revenue. If the problems are solved, the economy will improve.

“I see a good sign of change in the country, but it may not be seen in this government. It takes time, 10-20 years,” said Dr. Supasaek.

“I have hope, though I am unsure there will be a change from the government side,” said Sasima.

By Neeranuch Kunakorn

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