Health Services for Intellectually Disabled in Thailand

บทคัดย่อ

          The history of public health services for the intellectually disabled in Thailand, according to western medicine, began in 1889 when Somdet Chao Praya Hospital, the first psychiatric hospital in Thailand was founded. At that time the services provided for intellectually disabled patients were integrated with those provided for psychiatric patients. This system existed until 1950 when there was a change in the concept of these services, based on the idea that intellectually disabled patients were different from psychiatric patients in general. Therefore, the treatment for such patients must be different. Putting the intellectually disabled patients with the psychiatric patients had proved to be more detrimental than beneficial. Consequently, the Ministry ofPublic Health came up with a plan to provide services for intellectually disabled patients in particular. As a result, Rajanukul, a hospital for intellectually disabled patients was set up in Bangkok in 1960. This hospital was built to provide services for intellectually disabled patients nationwide. The model of service was
to admit patients to receive such treatment as medical treatment and rehabilitation, educational rehabilitation, vocational training and social rehabilitation. However, being the only hospital providing these services to such patients it was unable to meet demand and failed to fulfill the patients' needs. Thus the Ministry ofPublic Health founded the Northern Child Development Centre in Chiangmai Province in the northern part of Thailand in 1994 which became the country's second hospital for the intellectually disabled. In 1980 the concept of primary health care was introduced which included the delivery of services via community centres etc. Admitting patients to the hospital for a long periods had proved to be detrimental to patients for a variety of reasons. For example, their adaptive behaviours decreased and the hospital's inability to discharge patients meant that it was unable to admit new patients. As a result, only a limited number of patients had access to the hospital's services. However, when the concept of primary health care was introduced this problem was ameliorated. Nevertheless, many patients still could not access certain services, details of which will be further explained later on.