The Experiences of the Department of Mental Health, Thailand in helping the survivors from the Tsunami Disaster By Dr.Wachira Pengjuntr, M.D. Deputy Director General Department of Mental Health Ministry of Public Health, Thailand 2 3 4 5 Health Care System in Thailand Office of the Permanent Secretariat The Permanent Secretariat
The Local Administration
Provincial Public Health Office Head Of the Provincial Public Health Office
District Public Health Office Head of the District Public Health Office
Provincial Hospitals/General Hospitals (93)
Community Hospitals (716)
Health Office (4,000+) 6 Mental Health Services System
Ministry of Public Health University Hospitals
Ministry of Defense Hospitals Dept. of Mental Health Ministry of Interior Hospitals Tertiary Care Psychiatric Hosp.(17) Bangkok Metropolitan Hospitals
Office of PermanentSecondary Care Secretary General Hosp. MOPH Primary Care Private Hospitals and Clinics Comm. Hosp./ Health Center
People with mental problems Psychiatric patients
7 Management of patients with mental disorders
Psychiatric Hosp. Both 13% 9%
78%
Primary & Secondary Care setting
8 The Roles and Responsibilities of The Department of Mental Health
During the Emergency Phase
9 Established the Mental Health Center for Thai Tsunami Disaster ( MHCT) at The Department of Mental Health, Ministry of Public Health, Nonthaburi Province
10 Department of Mental Health
Mental Health Center for Thai Tsunami Disaster
The mobile teams Suan Saranrom Psychiatric in the 6 provinces Hospital in Surat thani 11 12 A Teleconference Room at the MHCT
13 14 15 16 Set up Mental Health Mobile Teams Each team consists of 10 personnel 1 Psychiatrist 2-3 Psychologists 1 Social Worker 2 Psychiatric Nurses 1 Pharmacist 1 Assistant Nurse 1 Driver
17 18 19 The Responsibilities of the Mobile Teams
20 21 22 23 24 25 26 The Roles and Responsibilities of The Department of Mental Health
During the Post Impact Phase
27 New Concept
• From Providers to Facilitators • From Victims to Survivors • From Function Oriented to Area Oriented • From Individual to Family and Community
28 Deliver psychoeducation through variousvarious mediamedia
Website MHCT @ http://www.dmh.go.th/dmhmcc/dmh_tsunami//
29 Public Education
30 Training health personnel and volunteers
31 32 Training the Volunteers
33 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 System
34 35 Organized the workshop and conferences
36 37 38 Post Tsunami Mental Health Assessment (8th weeks post-disaster) Adult : From DMH & TUC Displaced Community Community % Phang Nga Krabi/Phuket Severe PTSD 12.1 6.8 3.0 Mod. PTSD 15.4 11.2 6.2 Children : Displaced Community % Phang Nga/ Krabi/Phuket Severe PTSD 13.3 8.1 Mod.PTSD 31.6 28.3 The Roles and Responsibilities of The Department of Mental Health
During the Recovery Phase
40 Strengthening the network in the community for the continuous and permanent recovery
41 The meeting at the Center of Public Health Surveillance and Relief After Tsunami Disaster
In the six southern provinces of Thailand
42 Plans of the Intervention and Rehabilitation for the Tsunami survivors (2005-2006) Guideline to Follow Up and Rehabilitation 2 months – 2 years period after the Tsunami Disaster
Health Center/Community Promote Community Actions
H.C./Community Home visit/ Community Health Status Assessment Basic At Risk ? N Counseling Y Refer to Provincial/General Hosp./Comm. Hosp.
Treatment Comm./Gen.Hosp. 1 Year Follow up? Y Follow up N
Provincial/Psychiatric Hosp. Psychiatric Team 44 GuidelineGuideline forfor PrimaryPrimary CareCare andand ReferringReferring SystemSystem
Comm./Gen.Hosp. Patients Admission from The Community
N BasicBasic Nurses Screening CounselingCounseling Y Medical Doctor Diagnosis N Y Doctor + Nurse Treat by medicine & Counseling
Doctor + Nurse 1 Year Follow up
N Doctor Patients with Severe Symptom Y Provincial/Psychiatric Hosp. Psychiatric Team 45 - Psychoeducation for Public - Training Courses for the community leaders such as VHV, monks, imam, etc. - Follow up the risk group and the patients - Surveillance on PTSD, Depression, Suicide and Drug Abuse - Research study - Database and report system development
46 Ment al Health Recover y Center
ศ ูนยฟนฟูสุขภาพจิต กรมสขุ ภาพจิต
47 Thank you
48