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Situations and Trends in Mental Disorders
Since the implementation of the Seventh National Economic and Social Development Plan (1992-1996), Thai society has become increasingly aware of the problem of mental disorders and related issues. The existing health data are principally concerned with birth and death while the available data on mental health are quite limited. A lot of mental health data have to do with mental health services, making it difficult to make projections of overall trends in mental disorders. The situations and trends on mental health problems in Thai people to be covered in this chapter deal with the following topics:
1. Mental health burdens,
2. Data on mental health problems: suicides,
3. Data on major mental disorders,
4. Drug abuse,
5. Mental health problems in children and adolescents.
3. Relevant Data on Mental Health Disorders
3.1 Psychosis
The numbers and rates of psychotic patients per 100,000 population in Thailand from 1997 to 2001 show an upward trend. By visit to health facilities, general health facilities have to treat increasing numbers of psychotic patients. In fiscal 1997, the rate of 144.0 per 100,000 population rises to 293.2 per 100,000 population in fiscal 2001. However, at health facilities under the Department of Mental Health is found a downward trend in the rate of patients. Particularly in fiscal 1997, there are 298.70 psychotic patients per 100,000 population but in fiscal 2001, the rate is reduced to 228.2 per 100,000 population (Figures 2-7 and 2-8), owing perhaps to the expansion of psychiatric service delivery in general health facilities, making it easier for the population to gain access to health services and facilities that are closer to home.
Figure 2-8 Rate of psychotic patients of Thailand per 100,000 population, fiscal 1997-2001
Figure 2-9 Rate of psychotic patients of Thailand per 100,000 population by visit to health facilities, fiscal 1997-2001
3.2 Mental Retardation
According to a report on the number and rate of mental patients per 100,000 population in Thailand from fiscal 1997 to 2001, no conclusion can be drawn on the trend of mental retardation occurrence. Both upward and downward trends are indicated (Figure 2-9). By health service facility frequented by users, it is found that the rate of mentally retarded patients at health facilities under the Department of Mental Health has been on the rise. In fiscal 1997, the rate of mentally retarded people is 8.95 per 100,000 population and rises to 17.03 per 100,000 in 2001. The increase perhaps is due to the fact that the departments facilities administer to mentally retarded patients in the middle to severe case bracket and has a rehabilitative program that enables the mentally retarded to develop the highest possible degrees of self-help. For general health facilities, the rate of the mentally retarded cannot be pinpointed as to what direction it may be headed, with both upward and downward rates showing (Figures 2-10 and 2-11).
Figure 2-10 Rate of mentally retarded patients per a population of 100,000 in Thailand, fiscal 1997-2001
Figure 2-11 Rate of mentally retarded patients per a population of 100,000 in Thailand at general health facilities, fiscal 1997-2001
Figure 2-12 Rate of mentally retarded patients per a population of 100,000 in Thailand at health facilities under the Department of Mental Health, fiscal 1997-2001
3.3 Anxiety Neurosis
According to a report on the number and rate of mental illnesses per a population of 100, 000 in Thailand from fiscal 1997 to 2001, the trend of anxiety neurosis patients cannot be pinpointed as to what direction it is headed, with alternately upward and downward swings. By health facility used, no discernible trend of anxiety neurosis patients can be pinpointed, with both an upswing and a downswing alternating. But at health facilities managed by the Department of Mental Health, the trend is on the downturn, owing perhaps to the habit of anxiety neurotics changing their health facilities and the diagnostic results on anxiety neurosis at health facilities are often kept hidden with diagnostic results of other types of illnesses (Figures 2-11 and 2-12).
Figure 2-13 Rate of anxiety neurosis patients per a population of 100,000 in Thailand, 1997-2001
Note: The data do not include Bangkok.
Source: Department of Mental Health, Ministry of Public Health.
Figure 2-14 Rate of anxiety neurosis patients per a population of 100,000 in Thailand at general health facilities, 1997-2001
Note: The data do not include Bangkok.
Source: Department of Mental Health, Ministry of Public Health.
3.4 Depressive Disorder
According to a report on the rate of mental illnesses per a population of 100,000 in Thailand from fiscal 1997 to 2001, the trend of depressive disorder patients cannot be pinpointed as to what direction it is headed, with both an upswing and a downswing occurring. By health facilities used, the trends of depressive disorder patients at both health facilities under the Department of Mental Health and general health facilities cannot be pinpointed, with both an upswing and a downswing occurring at both types of health facilities, owing perhaps to the diagnostic results of depressive disorder being hidden among other illnesses (Figures 2-15 and 2-16).
Figure 2-15 Rate of depressive disorder patients per a population of 100,000 in Thailand, 1997-2001
Figure 2-17 Rate of depressive disorder patients per a population of 100,000 in Thailand at general health facilities, 1997-2001
Note: The data do not include Bangkok.
Source: Department of Mental Health, Ministry of Public Health.
3.5 Alcoholics
From fiscal 1997 to 2001, the trend of the Thai population who are 15 years old and over taking up drinking is on the rise. In 1997, consumption of alcoholic beverages is 35.4 litres per person and rises to 41.6 litres per person in 2001. By type of alcoholic beverages consumed, the trend of alcohol consumption is constantly on the rise, with beer figures fluctuating between an upswing and a downswing. Wine consumption, however, is on an upward trend. No doubt, rising consumption of alcoholic drinks between the years 1997 and 2001 will take its toll on the imbibers health. It is found that the trend of alcoholic patients seeking treatment at health clinics nation-wide keeps rising. By old and new patients, the percentage of old alcoholic patients seeking treatment is constant while the trend of new patients is on the rise (Figure 2-19). The greatest portion of alcoholic addicts are male, at 90.9-92.9% while females stand at 7.1-9.1%, with a slight upward trend (Figure 2-20). By age group, the majority of alcoholic addicts are in the 30-44 age group, a working-age span. It is noteworthy that 0.1-1.2% of the patients seeking alcohol-related treatment are youth (Figure 2-21).
(Note: By alcoholic addict is meant any person who seeks mainly the 30-day pre-treatment for alcohol-related troubles before being admitted for treatment.)
Figure 2-18 Sales volumes of liquor, beer and wine per a population of 15 years old and over, 1997-2001
Note: Average consumption per a population of 15 years old and over.
Source: Excise Department, Ministry of Finance.
Figure 2-19 Percentage of alcoholics who seek treatment nation-wide by new and old patients, fiscal years 1997-2001
Source: Division for the Coordination of Drug Abuse Treatment, Department of Medical Services.
Figure 2-20 Percentage of alcoholics who seek treatment nation-wide by gender, fiscal years 1997-2001
Source: Division for the Coordination of Drug Abuse Treatment, Department of Medical Services.
Figure 2-21 Percentage of alcoholics who seek treatment nation-wide by age group, fiscal years 1997-2001
Source: Division for the Coordination of Drug Abuse Treatment, Department of Medical Services.
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