The Experiences Of The Department Of Mental Health .


The Experiences ofthe Department of Mental Health, Thailandin helping the survivors fromthe Tsunami DisasterByDr.Wachira Pengjuntr, M.D.Deputy Director GeneralDepartment of Mental HealthMinistry of Public Health, Thailand





Health Care System in ThailandOffice of the Permanent SecretariatThe Permanent SecretariatThe Local AdministrationProvincial Public Health OfficeHead Of the Provincial Public Health OfficeDistrict Public Health OfficeHead of the District Public Health OfficeProvincial Hospitals/General Hospitals (93)Community Hospitals (716)Health Office (4,000 )6

Mental Health Services SystemMinistry of Public HealthUniversity HospitalsMinistry of Defense HospitalsDept. of Mental HealthTertiary CarePsychiatric Hosp.(17)Ministry of Interior HospitalsBangkok Metropolitan HospitalsOffice of PermanentSecondary CareSecretaryGeneral Hosp.MOPHPrimary CareComm. Hosp./ Health CenterPrivate Hospitals and ClinicsPeople with mental problemsPsychiatric patients7

Management of patients with mental disordersPsychiatric Hosp.13%Both9%78%Primary & Secondary Care setting8

The Roles and Responsibilities ofThe Department of Mental HealthDuring the Emergency Phase9

Established the Mental Health Center forThai Tsunami Disaster ( MHCT)at The Department of Mental Health,Ministry of Public Health,Nonthaburi Province10

Department ofMental HealthMental Health Center forThai Tsunami DisasterThe mobile teamsSuan Saranrom Psychiatricin the 6 provincesHospital in Surat thani11


A Teleconference Room at the MHCT13




Set up Mental Health Mobile TeamsEach team consists of 10 personnel1 Psychiatrist2-3 Psychologists1 Social Worker2 Psychiatric Nurses1 Pharmacist1 Assistant Nurse1 Driver17



The Responsibilities of the Mobile Teams20







The Roles and Responsibilities ofThe Department of Mental HealthDuring the Post Impact Phase27

New Concept From Providers to Facilitators From Victims to Survivors From Function Oriented to AreaOriented From Individual to Family andCommunity28

Deliver psychoeducation through various mediaWebsite MHCT @ tsunami/29

Public Education30

Training health personnel and volunteers31


Training the Volunteers33

Main content of the training course Disaster and normal stress responses Roles and responsibilities of the helpers Secondary trauma and self care Early intervention for the survivors:psychological first aid, brief assessment, etc. Psychoeducation for public Working with families and communities Referring System34


Organized the workshop and conferences36



Post Tsunami Mental Health Assessment(8th weeks post-disaster)From DMH & TUCAdult :Severe PTSDMod. PTSDDisplaced%CommunityPhang ren :Severe PTSDMod.PTSDDisplaced%CommunityPhang Nga/ Krabi/Phuket13.331.68.128.3

The Roles and Responsibilities ofThe Department of Mental HealthDuring the Recovery Phase40

Strengthening the network in thecommunity for the continuous andpermanent recovery41

The meeting at the Center of Public Health Surveillance and Relief After Tsunami DisasterIn the six southern provinces of Thailand42

Plans of the Intervention andRehabilitation for the Tsunamisurvivors (2005-2006)

Guideline to Follow Up and Rehabilitation2 months – 2 years period after the Tsunami DisasterHealth Center/CommunityH.C./CommunityPromote Community ActionsHome visit/ Community Health Status AssessmentNAt Risk ?BasicCounselingYRefer to Provincial/General Hosp./Comm. Hosp.Comm./Gen.Hosp.1 Year Follow up?YTreatmentFollow upNProvincial/Psychiatric Hosp.Psychiatric Team44

Guideline for Primary Care and Referring SystemComm./Gen.Hosp.Patients Admission from The CommunityNNursesScreeningBasicCounselingYMedical DoctorNDiagnosisYDoctor NurseDoctor NurseDoctorTreat by medicine & Counseling1 Year Follow upNPatients with Severe SymptomYProvincial/Psychiatric Hosp.Psychiatric Team45

- Psychoeducation for Public- Training Courses for the communityleaders such as VHV, monks, imam, etc.- Follow up the risk group and the patients- Surveillance on PTSD, Depression, Suicideand Drug Abuse- Research study- Database and report system development46

Mental Health Recovery Centerศูนย ฟ นฟูสุขภาพจิต กรมสขุ ภาพจิต47

Thank you48

During the Emergency Phase. 10 Established the Mental Health Center for Thai Tsunami Disaster ( MHCT) at The Department of Mental Health, Ministry of Public Health, Nonthaburi Province . 11 Department of Mental Health Mental Health Center for Thai Tsunami Disaster The mobile teams in the 6 provinces Suan Saranrom Psychiatric Hospital in Surat thani. 12. 13 A Teleconference Room at the