Journal of Mental Health of Thailand

Public mental health: a topic which mental health personnel should know

Pichet Udomratn, M.D. — Tue, 23 Sep 2025 00:00:00 +0700

ในช่วงทศวรรษที่ผ่านมา ประเด็นเรื่อง public mental health ได้รับความสนใจเพิ่มมากขึ้นจากบุคลากรทางสุขภาพจิตในประเทศแถบตะวันตก¹ อย่างไรก็ตาม ในบริบทของประเทศไทย คำว่า public mental health ยังไม่เป็นที่กล่าวถึงอย่างแพร่หลาย และยังไม่มีบัญญัติแปลคำภาษาไทยอย่างเป็นทางการ ผู้นิพนธ์จึงขอเสนอใช้คำว่า “สุขภาพจิตสาธารณะ” เป็นคำแปลของ public mental health ในที่นี้

สุขภาพจิตสาธารณะ เป็นทั้งศาสตร์และศิลป์ในการส่งเสริมสุขภาวะทางจิต (mental wellness หรือ mental well-being) และป้องกันความเจ็บป่วยทางจิต ด้วยการเข้าถึงประชากรเป็นกลุ่ม (population-based approach) แทนที่จะมุ่งเน้นในระดับบุคคล อีกทั้งยังให้ความสำคัญกับความเท่าเทียมและเสมอภาคในการเข้าถึงบริการทางสุขภาพจิต² แนวคิดเรื่องสุขภาพจิตสาธารณะสอดคล้องและได้รับการสนับสนุนจากเป้าหมายการพัฒนาที่ยั่งยืน (Sustainable Development Goals: SDGs) ขององค์การสหประชาชาติ และแผนการดำเนินงานด้านสุขภาพจิตแบบครอบคลุม พ.ศ. 2556 - 2573 (Comprehensive Mental Health Action Plan 2013 - 2030) ขององค์การอนามัยโลก³...อ่านต่อในไฟล์บทความ...

Mental health literacy: a future competency towards sustainable mental health

Varoth Chotpitayasunondh, Ph.D. — Sat, 27 Sep 2025 00:00:00 +0700

Mental health has become a critical public health agenda both globally and in Thailand, amid escalating challenges and complex systemic issues. Mental health literacy (MHL), defined as the integration of knowledge, beliefs, personal attributes, and skills to recognize, manage, and prevent mental health problems, is widely recognized as a crucial proactive tool for fostering sustainable well-being in society.

This article aims to synthesize knowledge from research and policy documents to analyze the significance, current situation, and challenges of promoting MHL within the Thai context. It also proposes a conceptual framework and policy recommendations to support systematic development.

The review reveals that Thai society is facing a significant gap between the increasing demand for mental health services and the limited resources and service infrastructure, compounded by social stigma and misconceptions about mental health. Enhancing public MHL is therefore essential to overcoming these barriers, requiring the development of four core competencies: accessing information of mental health and services, acquiring understanding and awareness, appraising information critically, and applying knowledge for self-management and supporting others.

However, promoting MHL cannot be achieved by focusing solely on individuals. It requires systemic change and genuine collaboration across all sectors to create a sustainable mental well-being ecosystem.

Factors related to completed suicide among individuals with suicidal behavior in Nan province, Thailand

Weera Ek-anankul, M.D. — Tue, 23 Sep 2025 00:00:00 +0700

Objective: To compare characteristics between the group who completed suicide and the group who attempted suicide, and to identify factors associated with completed suicide.

Methods: This case-control study was conducted in Nan province, comparing the group who completed suicides and those who attempted suicide. Secondary data from medical records and semi-structured interview notes by psychiatric personnel were used, covering general characteristics, suicide patterns, predisposing factors, precipitating factors, and protective factors. Differences between groups were analyzed using chi-square and Mann-Whitney U tests. Predictors of completed suicide were identified using binary logistic regression.

Results: The sample included 163 subjects, divided into 69 completed suicides and 94 attempts. Compared to the attempt group, the completed suicide group had significantly higher median age and proportions of males, being employed, and use of violent methods such as hanging. Factors that significantly increased the likelihood of completed suicide were male gender (AOR = 4.68, 95% CI = 1.82 - 11.98), presence of physical health problems (AOR = 9.55, 95% CI = 1.55 - 57.75) and lack of self-problem-solving skills (AOR = 3.11, 95% CI = 1.02 - 9.49).

Conclusion: Systematic screening and prevention of completed suicide should be implemented, taking gender differences into account and focusing on high-risk groups facing life crises, especially health and economic issues. Emphasis should also be placed on promotion of self-problem-solving skills to enable adaptive coping with crisis situations.

Effects of telephone motivational counseling program on resilience among family members of alcoholics

Jinna Lawang, B.S., Pakawan Nantasen, Ph.D. — Tue, 23 Sep 2025 00:00:00 +0700

Objective: To examine the effects of a telephone motivational counseling program on resilience among family members of alcoholics.

Methods: This study employed a two-group, pretest-posttest, quasi-experimental design. The sample consisted of 20 family members of alcoholics with low resilience levels who received services from the Alcohol and Drug Helpline Centre (Quitline 1413). Participants were divided into two groups of 10 each. The control group received three initial sessions of mental health information within one month, in accordance with the service guidelines of the center. The experimental group received a telephone motivational counseling program consisting of eight weekly sessions, each lasting 45 minutes. Resilience scores before and after the intervention were measured using the 3-item version of the Resilience Inventory. Data were analyzed using descriptive statistics, the chi-square test, the Wilcoxon signed-rank test, and the Mann-Whitney U test.

Results: Participants were mostly female (80%) and aged between 40 and 60 years (65%). Before the intervention, resilience scores were not significantly different between the control and experimental groups. After the intervention, the experimental group showed significantly higher resilience scores compared to their pre-intervention scores. Additionally, the experimental group demonstrated significantly higher resilience scores than the control group.

Conclusion: The telephone motivational counseling program was effective in increasing resilience among family members of alcoholics with low resilience levels, compared to the standard telephone service.

Risk factors for severe alcohol withdrawal syndrome in Lamphun hospital

Chonthicha Rueangwiriyanan, M.D. — Wed, 24 Sep 2025 00:00:00 +0700

Objective: To identify factors associated with severe alcohol withdrawal syndrome among patients with alcohol withdrawal syndrome.

Methods: This retrospective study included patients who were hospitalized at Lamphun hospital from October 1, 2022, to September 30, 2023, and presented with alcohol withdrawal syndrome. Demographics, history of alcohol use and related treatment, laboratory results and vital signs at admission, and Alcohol Withdrawal Scale (AWS) scores were retrieved from medical records. Data were analyzed using descriptive statistics and multivariate logistic regression.

Results: Among 190 patients, 87.4% were male with a mean age of 48.9 years. Of these, 38.9% had physical comorbidities, and 93.7% were regular alcohol consumers. Factors significantly increasing risk of developing severe withdrawal syndrome (AWS $\geq$ 10) included regular alcohol consumption, smoking, history of alcohol withdrawal, prior treatment for alcohol withdrawal, alcohol-induced transient amnesia, abnormal laboratory results (liver function tests, blood sugar/DTX, creatinine, calcium, magnesium, and potassium), systolic blood pressure > 110 mmHg, and pulse rate > 100 beats per minute at admission.

Conclusion: A monitoring and management protocol should be developed for patients at risk of severe alcohol withdrawal syndrome, particularly those with regular alcohol consumption, a history of alcohol withdrawal, and abnormal laboratory or vital sign findings at admission, in order to prevent related complications and mortality.

Factors associated with the quality of life among caregivers of children with autism spectrum disorder

Wed, 24 Sep 2025 00:00:00 +0700

Objective: To identify factors associated with the quality of life (QoL) of caregivers of children with autism spectrum disorder (ASD).

Methods: A cross-sectional study was conducted among caregivers of children with ASD receiving services at the Rajanukul Institute. Data were collected using a series of questionnaires, including caregiver and child socio-demographic information, characteristics of ASD, comorbid conditions, the Perceived Stress Scale, the Brief COPE Inventory, a social support scale, and the WHO-Quality of Life-Brief (WHOQOL-BREF). Data were analyzed using descriptive statistics, point-biserial correlation, Spearman’s rank correlation, and eta coefficient.

Results: Among the 302 participants, 79.1% were female, and 63.9% were mothers. The severity of ASD was moderate in 53.6% of the children. Most caregivers reported moderate levels of stress, social support, overall QoL, and QoL across all four domains. The majority employed adaptive stress coping strategies more frequently than maladaptive ones. Caregiver QoL revealed statistically significant positive correlations with income, adequacy of income, and the levels of social support received from family, friends, caregiver networks, and healthcare personnel. Conversely, caregiver QoL was negatively correlated with stress levels, maladaptive stress coping, and the presence of comorbidities in the child.

Conclusion: Regular assessment of caregiver stress and quality of life is essential. Enhancing stress management skills, promoting awareness and understanding, and fostering strong family and community relationships can enhance caregiver roles and promote sustainable development in children with ASD.

The relationships among family functioning, gaming addiction, and violent behavior in children and adolescents: study during the COVID-19 pandemic

Thu, 25 Sep 2025 00:00:00 +0700

Objective: To explore the relationships among family functioning, violent behavior, and game addiction in children and adolescents during the COVID-19 pandemic.

Methods: A mixed method approach was employed. Quantitative data were collected via an online cross-sectional survey, involving 596 parents of children aged 6 - 18 years across four regions of Thailand. The questionnaires included socio-demographic information, the Chulalongkorn Family Intervention, the Game Addiction Screening Test, and the Adolescent Violent Behavior Inventory. Data was analyzed using descriptive statistics, chi-square tests, multivariate linear regression, and path analysis. Qualitative data was obtained through in-depth interviews with 15 parents of children and adolescents at risk of gaming addiction. Narrative analysis was used to interpret the qualitative findings.

Results: The findings revealed that 32.4% of families demonstrated poor levels of family functioning. Among children and adolescents, 26.7% were likely to have gaming addiction, while 4.6% exhibited violent behavior. Family functioning was found to have a weak negative correlation with violent behavior (r = -0.332), both directly and indirectly via gaming addiction. Gaming addiction had a weak positive correlation with violent behavior (r = 0.362). According to the interviews, parents reported that, during the pandemic, their children were more addicted to games due to increased screen time and lack of constructive activities. Parents also reported being unable to properly supervise their children due to struggling with time management. Many also acknowledged concerns about being poor role models because of their own excessive media use.

Conclusion: The COVID-19 pandemic negatively impacted family functioning, game addiction, and violent behavior among Thai children and adolescents. These findings underscore the importance of promoting appropriate parenting skills and strengthening family functioning as protective factors for children's mental health during times of social crisis.

Research and development of the P-PORCH case management model to improve medication adherence in patients with severe and persistent schizophrenia

Fri, 26 Sep 2025 00:00:00 +0700

Objective: To develop and evaluate the effect of a case management-based care model on medication adherence in severe and persistent schizophrenic patients.

Methods: This research and development study consisted of two phases. The first phase developed the care model, using expert group discussions, document reviews, and literature reviews. The second phase evaluated the effect of the model using a quasi-experimental, one-group pretest-posttest design. Participants were patients with severe and persistent schizophrenia who had experienced relapse due to medication non-adherence. Medication adherence scores were measured before and after intervention, and at 1- and 3- month follow-ups. Data were analyzed using repeated measures ANOVA.

Results: The P-PORCH model is a case management approach focusing on mindfulness, self-awareness (insight), and self-care skills. It consists of six steps: preparing a case manager, patient care planning, operation, regulatory monitoring, (multidisciplinary) coordination, and health care evaluation. The model includes 14 activities delivered over a 20-day period. Preliminary testing with 40 participants showed a statistically significant increase in medical adherence scores immediately after the intervention, which remained stable or showed a slight decline during the 3-month follow-up.

Conclusion: The P-PORCH model can be integrated into the care of patients with schizophrenia who experience medication non-adherence, and shows potential to improve treatment adherence in this challenging population.

Characteristics of communities for supporting substance use prevention: a scoping review

Jidapa Senwirat, B.Sc., Thanaphat Khamthuam, B.Sc., Navinee Regnault, M.Sc. — Mon, 29 Sep 2025 00:00:00 +0700

Objective: To identify key community characteristics that effectively support the prevention of substance use.

Methods: A scoping review was conducted, synthesizing evidence from 30 review articles encompassing over 1,050 studies across various contexts.

Results: Ten community characteristics were identified as protective factors against substance use, including strong social cohesion, equitable access to resources, effective policy enforcement, and cultural engagement. The findings also emphasize the value of multi-level approaches that integrate social, economic, and environmental dimensions to strengthen community resilience and reduce the risk of substance use.

Conclusion: This review offers practical insights for policymakers and public health professionals in developing sustainable, community-based strategies for substance use prevention.