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วันที่โพสต์

26 ก.ย. 2024

ประเภทบทความ

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Mental Health Promotion and Community Initiatives

Promoting mental health and initiating community-driven projects are crucial for enhancing overall well-being and preventing mental health disorders. As mental health challenges become increasingly prevalent globally, the importance of these efforts cannot be overstated. Thailand has made remarkable strides in advancing mental health promotion at the community level, offering a model that other countries might consider adopting.

Mental health promotion entails creating environments that support mental wellness and equipping individuals with the skills necessary to manage stress and sustain positive mental health. This proactive approach goes beyond simply addressing mental illness; it involves fostering a culture where mental health is prioritized and integrated into daily life. Community initiatives are pivotal in this process, as they bring mental health services and education directly to the people, fostering a sense of belonging and support essential for effective mental health care (Kohrt et al., 2018).

At its core, mental health promotion involves a broad array of activities designed to boost mental well-being and prevent mental health issues. This can include public education campaigns, integrating mental health services into primary healthcare systems, and implementing community-based interventions (Singh et al., 2022). Such strategies are not only essential for improving individual mental health but also for enhancing societal outcomes. By addressing mental health proactively, communities can reduce healthcare costs, improve productivity, and foster a healthier, more engaged population. Importantly, these strategies must be culturally sensitive, evidence-based, and inclusive, ensuring they meet the diverse needs of all population segments. Community initiatives, particularly, are crucial in regions with limited formal healthcare services. They utilize local resources and knowledge, provide culturally relevant support, and help to overcome barriers to accessing mental health care (Kohrt et al., 2018).

Thailand's approach to mental health promotion has a rich history that reflects broader global trends. Historically, mental health care in Thailand was predominantly institutional, but the country has gradually shifted towards community-based services. This transition is marked by the implementation of several significant policies and frameworks to support mental health promotion. Notably, the National Mental Health Act and the Mental Health Strategic Plan have been instrumental in ensuring that mental health is recognized as a national priority. These frameworks emphasize the importance of treatment, rehabilitation, prevention, and promotion, illustrating Thailand's commitment to a comprehensive approach to mental health (Wannasewok et al., 2022). Key organizations in this effort include the Department of Mental Health (DMH), various non-governmental organizations (NGOs), and local community groups, all of which play vital roles in advancing mental health initiatives (WHO, 2023).

Among Thailand's notable community mental health programs is the Village Health Volunteer (VHV) program. This initiative trains community members to provide essential health services within their local areas, including mental health support. The VHVs are a crucial link between the community and formal health services, facilitating early detection and intervention for mental health issues (Wannasewok et al., 2022). Another successful initiative is school-based mental health programs that promote mental well-being among children and adolescents. These programs often include mindfulness training, peer support groups, and mental health education. Addressing mental health at an early age can help build resilience and foster a supportive environment for young people (Sati App, 2024). Additionally, traditional practices and local cultural elements are integral to Thailand's mental health promotion. Practices such as meditation, along with the involvement of monks in mental health care, are incorporated into community initiatives, providing support that is culturally relevant and widely accepted (Sukmak & Sipola, 2019).

Despite these advancements, Thailand faces several challenges in its mental health promotion efforts. Cultural stigma and misconceptions about mental health issues remain significant barriers. Many individuals with mental health problems continue to face discrimination, which can deter them from seeking the help they need. For example, societal beliefs in Thailand often attribute mental health issues to spiritual or supernatural causes rather than medical or psychological factors. This cultural context can lead to reluctance to seek professional help and a preference for traditional or religious remedies. Furthermore, resources and funding for mental health initiatives are often insufficient, limiting the scale and sustainability of these programs. There is a pressing need for increased investment in mental health initiatives to address these challenges, particularly in rural and underserved areas where resources are most scarce. Additionally, training and capacity-building for community health workers are critical. These workers must receive ongoing education and support to remain effective and knowledgeable about best practices (Kohrt et al., 2018). Evaluating and measuring the effectiveness of mental health programs is another crucial area that needs attention. Robust evaluation frameworks are necessary to assess the impact of various initiatives and guide future improvements (Singh et al., 2022).

Comparing Thailand's mental health promotion efforts with those in other South Asian, Southeast Asian, or developing countries provides valuable insights and fosters a deeper understanding of effective strategies. For instance, in Indonesia, integrating mental health services into primary care settings and utilizing community health workers have shown promising results. The "Puskesmas" model, where primary health care centers provide mental health services, helps increase access and reduce stigma by making mental health care part of routine health services (Kohrt et al., 2018). Similarly, the Philippines has made significant strides through its "Mental Health Law," which emphasizes community-based care and the involvement of local stakeholders. Programs in the Philippines focus on training community health workers and establishing mental health services within local health centers, contributing to a more comprehensive and accessible mental health care system (Singh et al., 2022).

Examining these strategies reveals commonalities and differences. In Thailand, the emphasis on integrating mental health services into primary care and leveraging community health workers mirrors approaches seen in other countries. However, the specific programs and levels of integration vary. For instance, while Thailand incorporates traditional practices into its mental health care, countries like Indonesia focus on integrating mental health services into existing health infrastructures, and the Philippines emphasizes legal frameworks and training. These variations reflect different local needs and resource availability.

The comparison also highlights shared challenges, such as limited resources and funding, which affect the scale and sustainability of mental health programs. Despite progress, Thailand faces issues similar to those in other developing countries in securing adequate funding and resources for mental health initiatives. Addressing these challenges requires innovative solutions and international collaboration to enhance resource allocation and program effectiveness.

Exploring the successes and challenges other developing countries face can offer Thailand new strategies for improving its mental health promotion efforts. For example, leveraging technology and social media to raise awareness and support, as seen in some Southeast Asian countries, could expand Thailand's reach and impact (WHO, 2023). Similarly, the emphasis on community involvement and participatory approaches, thriving in various contexts, can be further refined and adapted to meet Thailand's unique needs.

Promoting mental health and supporting community-driven initiatives are fundamental to a healthier society. Thailand's approach, characterized by community involvement and culturally sensitive practices, offers valuable lessons for other nations. A holistic and community-driven approach to mental health promotion can significantly improve mental well-being and resilience. Support and innovation are crucial for sustaining these efforts and addressing emerging challenges. By embracing a comprehensive and inclusive approach to mental health promotion, Thailand can continue fostering mental well-being and community resilience.

 

References;

Chisholm, D., Docrat, S., Abdulmalik, J., Alem, A., Gureje, O., Gurung, D., Hanlon, C., Jordans, M. J. D., Kangere, S., Kigozi, F., Mugisha, J., Muke, S., Olayiwola, S., Shidhaye, R., Thornicroft, G., & Lund, C. (2019). Mental health financing challenges, opportunities and strategies in low- and middle-income countries: findings from the Emerald project. BJPsych Open, 5(5), e68–e68. https://doi.org/10.1192/bjo.2019.24

Kohrt, B. A., Asher, L., Bhardwaj, A., Fazel, M., Jordans, M. J. D., Mutamba, B. B., Nadkarni, A., Pedersen, G. A., Singla, D. R., & Patel, V. (2018). The Role of Communities in Mental Health Care in Low- and Middle-Income Countries: A Meta-Review of Components and Competencies. International Journal of Environmental Research and Public Health, 15(6), 1279-. https://doi.org/10.3390/ijerph15061279

Sati App. (2024). Sati App Impact Report 2023-2024. https://www.satiapp.co/wp-content/uploads/2024/05/Sati-App-Impact-Report-2023-2024.pdf

Singh, V., Kumar, A., & Gupta, S. (2022). Mental Health Prevention and Promotion—A Narrative Review. Frontiers in Psychiatry, 13, 898009–898009. https://doi.org/10.3389/fpsyt.2022.898009

Sukmak, V., & Sipola, S. (2019). An Ethnographic Study of Mental Healthcare Services for People with Mental Illness in Rural Thailand. Issues in Mental Health Nursing, 40(1), 58–64. https://doi.org/10.1080/01612840.2018.1440449

Wannasewok, K., Suraaroonsamrit, B., Jeungsiragulwit, D., & Udomratn, P. (2022). Development of Community Mental Health Infrastructure in Thailand: From the Past to the COVID-19 Pandemic. Consortium Psychiatricum (English Ed. Online), 3(3), 98–109. https://doi.org/10.17816/CP194

World Health Organization (WHO). (2023). Uniting for Mental Health: Providing Safe Spaces for Youth Through 'What’s This Feeling?' Campaign. https://www.who.int/thailand/news/detail/10-10-2023-uniting-for-mental-health--providing-safe-spaces-for-youth-through--what-s-this-feeling---campaign

 

Author: Zekima Rashid is a postgraduate (Master of Public Health) student at St. Catherine University in the United States. She worked as an intern at TIMS in July and August of 2024.

วันที่โพสต์

26 ก.ย. 2024

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