Развитие амбулаторной психиатрической службы в Таиланде: от прошлого к настоящему во время пандемии COVID-19

Таиланд — страна с уровнем дохода выше среднего, расположенная в центре материковой части Юго-Восточной Азии, с населением 66,17 млн человек в 2021 году. Цель данной обзорной статьи — проанализировать этапы развития амбулаторной психиатрической службы в нашей стране. Статья разделена на пять основных разделов, а именно: система охраны психического здоровья, система амбулаторной психиатрической службы, кадровые ресурсы, финансирование психиатрической помощи, просвещение населения и связи с другими секторами. С 1982 года психиатрическая помощь интегрирована в первичную медико-санитарную помощь, что привело к значительному увеличению внимания к психическому здоровью на общественном уровне; однако проблемы в области психического здоровья и недостаточная доступность психиатрической помощи все еще существуют, особенно во время пандемии COVID-19. Амбулаторная психиатрическая служба охватила структуры, не входящие в систему здравоохранения, в том числе и органы местного самоуправления. Данная служба включает психиатрическую помощь и реабилитацию, а также укрепление психического здоровья и профилактику психических расстройств, ее задача заключается в повышении доступности помощи, особенно во время пандемии. Наконец, рассмотрены требующие решения проблемы амбулаторной психиатрической службы, такие как нехватка персонала для создания реабилитационной службы для людей с хроническими тяжелыми психическими заболеваниями, привлечение финансирования от других заинтересованных сторон, а также забота о психическом здоровье людей с постковидным синдромом в условиях привычной социальной среды.

1. Community Mental Health: Thailand Country Report 2008 [Internet]. Department of Mental Health, Ministry of Public Health. [cited 2022Sep.22]. https://dmh.go.th/download/Ebooks/CommuMH2551/rptCommunity2008eng.pdf.
2. Keyes JE. Thailand — Britannica [Internet]. Encyclopædia Britannica. [cited 2022Sep.22]. https://www.britannica.com/place/Thailand.
3. Thailand in Brief. Demographic. [Internet]. Thailand Board of Investments. [cited 2022Sep.22]. https://www.boi.go.th/index.php?page=demographic.
4. The Bureau of Registration Administration. The announcement of the Central Registration Office: Number of population in the Kingdom of Thailand. [Internet]. Bangkok: Department of Provincial Administration; 2022. [cited 2022Sep.22]. http://www.ratchakitcha.soc.go.th/DATA/PDF/2565/E/012/T_0010.PDF.
5. The World Bank in Thailand: Overview. [Internet]. The World Bank. [cited 2022Sep.22]. https://www.worldbank.org/en/country/thailand/overview#1.
6. Thanaudom K, Jampathong N, Udomratn P. One hundred and thirty years of psychiatric care in Thailand: Past, present, and future. Taiwanese J Psychiatry (Taipei). 2018 Jan;32(1):9–17.
7. Prevalence of mental disorders and mental health problems: Results of the Thai National Mental Health Survey 2013. [Internet]. Nonthaburi (Thailand): Department of Mental Health. [cited 2022Sep.22]. https://dmh.go.th/ebook/files/prevalence_of_M_disorder_MH_problems_TNMHS2013.pdf.
8. Institutional Repository for Information Sharing. World Health Organization assessment instrument for mental health systems, WHO-AIMS version 2. January 1, 2005. [Internet]. World Health Organization. [cited 2022Sep.22]. https://apps.who.int/iris/handle/10665/70771.
9. Kwansanit P, Srisurapanont M. The parameters for calculating the burden of schizophrenia in Thailand. J Mental Health Thailand. 2018;26(1):50–62.
10. Kittitharaphan W, Wattanasuksa P. Years lived with disability from autism spectrum disorders in Thailand. J Mental Health Thailand. 2018;26(1):16–26.
11. Panyawong W, Santitadakul R, Pavasuthipaisit C. Prevalence of depression and suicidal risks in Thai adolescents: a survey in schools from 13 Public Health Region. J Mental Health Thailand. 2020;28(2):136–149.
12. Visanuyothin T, Pavasuthipaisit C, Wachiradilok P, Arunruang P, Buranasuksakul T. The prevalence of attention deficit/hyperactivity disorder in Thailand. J Mental Health Thailand. 2013;21(2):66–75.
13. National suicide prevention center. Report on Thailand’s suicide rate. [Internet]. KhonKaen (Thailand): KhonKaen Rajanagarindra Psychiatric Hospital. [cited 2022Sep.22]. https://suicide.dmh.go.th/report/suicide/stat_prov.asp.
14. Department of Mental Health. Mental Health Check In DASHBOARDS. [Internet]. Nonthaburi (Thailand): Department of Mental Health. [cited 2022Sep.22]. https://checkin.dmh.go.th/dashboards.
15. WHO-AIMS REPORT ON MENTAL HEALTH SYSTEM IN THAILAND [Internet]. World Health Organization. 2006 [cited 2022Sep.22]. https://cdn.who.int/media/docs/default-source/mental-health/who-aims-country-reports/thailand_who_aims_report.pdf?sfvrsn=853b6294_3&download=true.
16. The ASEAN Secretariat. ASEAN mental health systems. [Internet]. ASEAN Secretariat. 2016 [cited 2022Sep.22]. https://asean.org/wp-content/uploads/2017/02/55.-December-2016-ASEAN-Mental-Health-System.pdf.
17. Department of Mental Health. Stucture of the Department of Mental Health. [Internet]. Nonthaburi (Thailand): Department of Mental Health. 2016 [cited 2022Sep.22]. https://dmh.go.th/intranet/structure/chart02/.
18. Mental Health Atlas 2020 Country Profile: Thailand. January 1, 2020. [Internet]. World Health Organization. 2022 [cited 2022Sep.22]. https://cdn.who.int/media/docs/default-source/mental-health/mental-health-atlas-2020-country-profiles/mental-health-atlas-tha-2020-country-profile.pdf?sfvrsn=41911214_1&download=true.
19. Department of Mental Health. Annual report 2021 [Internet]. Bangkok: Ministry of Public Health; [cited 2022Sep.22] https://dmh.go.th/ebook/files/รายงานประจำปีกรมสุขภาพจิต%20ปีงบประมาณ%202564.pdf.
20. Office of the Counsil of State. Mental Health Act, B.E. 2551. February 13, 2008. [Internet]. Bangkok (Thailand): Office of the Council of State. 2008 [cited 2022Sep.22]. http://web.krisdika.go.th/data/document/ext810/810000_0001.pdf.
21. Mental Health Strategy and Planning Division, Department of Mental Health. The Mental Health Act. July, 2019. [Internet]. Nonthaburi (Thailand): Department of Mental Health. 2019 [cited 2022Sep.22]. https://necam.go.th/wp-content/uploads/2020/11/02รวมกฎหมาย-พรบ.สุขภาพจิต-พ.ศ.2551-และที่แก้ไขเพิ่มเติม-ฉบับที่-2-พ.ศ.-2562-1.pdf.
22. Thailand’s National Mental Health Plan B.E. 2561-2580. Department of Mental Health. [Internet]. Nonthaburi (Thailand): Department of Mental Health; 2019 [cited 2022Sep.22]. https://www.dmh-elibrary.org/files/original/3a3fce5f017f6d4b9ecad0b22d820658.pdf.
23. The Ministry of Public Health. Health resources/psychiatrist. [Internet]. Nonthaburi (Thailand): The Ministry of Public Health. 2022 [cited 2022Sep.22]. http://gishealth.moph.go.th/healthmap/resdetail.php?st=2&nd=15&rd=15&l1=7&l2=&l3=&ft=1&t=4.
24. Department of Mental Health. Manual of care service system for patients with serious mental illness at high risk for violence. June 1, 2020. [Internet]. Nonthaburi (Thailand): Department of Mental Health. 2020 [cited 2022Sep.22]. http://www.mhso.dmh.go.th/fileupload/202010061612167390.pdf.
25. Arunpongpaisal S, Kongsuk T, Maneethorn N, Maneethorn B, Wannasawek K, Leejongpermpoon J, Kenbupa K, Budwong S. Development and validity of two-question screening test for depressive disorders in Northeastern Thai community. Asian J Psychiatr. 2009 Dec;2(4):149–52. doi: 10.1016/j.ajp.2009.10.002. PMID: 23051095.
26. Kongsuk T, Arunpongpaisal S, Loiha S, Maneeton N, Wannasewok K, Leejongpermpoon J, Kenbubpha K. Development and validity of 9 questions for assessment of depressive symptom in Thai I-san community. Presented at: 6th International Workshop on Mental Health and Well-being: Sensing and Intervention. 2007. [Internet]. Researchgate. 2008. https://www.researchgate.net/publication/291800462_The_development_and_validity_of_9_questions_diagnostic_test_for_depressive_disorders_in_Thai_I-san_community.
27. Kongsuk T, Supanya S, Kenbubpha K, Phimtra S, Sukhawaha S, Leejongpermpoon J. Services for depression and suicide in Thailand. WHO South East Asia J Public Health. 2017 Apr;6(1):34–38. doi: 10.4103/2224-3151.206162. PMID: 28597857.
28. Sirithongthaworn S. The development of the Developmental Surveillance and Promotion Manual; DSPM. J Psychiatric Association Thailand. 2018;63(1):3–12.
29. Child and Adolescent Mental Health Rajanagarindra Institute (CAMRI). School Health HERO Project. [Internet]. Child and Adolescent Mental Health Rajanagarindra Institute. 2016 [cited 2022Sep.22]. https://new.camri.go.th/เครือข่าย-ฐานข้อมูล/School-Help-HERO.
30. Department of Mental Health. Mental Health Check In DASHBOARDS. [Internet]. Non-thaburi (Thailand): Department of Mental Health. 2022 [cited 2022Sep.22]. https://checkin.dmh.go.th/dashboards/dash04.
31. The Ministry of Public Health. Health resources. [Internet]. Nonthaburi (Thailand): The Ministry of Public Health. 2022 [cited 2022Sep.22]. http://gishealth.moph.go.th/healthmap/index.php?region=00&level1=2&level2=15&submit=แสดงข้อมูล.
32. The Medical Council of Thailand. Statistics of specialized physicians during 1964–2021. December 7, 2021. [Internet]. The Medical Council of Thailand. 2021 [cited 2022Sep.22]. https://www.tmc.or.th/pdf/stat-med-2021-004.pdf.
33. The Ministry of Public Health. Number of healthcare personnel/psychiatrist. [Internet]. Nonthaburi (Thailand): The Ministry of Public Health. 2022 [cited 2022Sep.22]. http://gishealth.moph.go.th/healthmap/resource.php.
34. The Ministry of Public Health. Healthmap/charts. [Internet]. Nonthaburi (Thailand): The Ministry of Public Health. 2022 [cited 2022Sep.22]. http://gishealth.moph.go.th/healthmap/chartst.php.
35. The Occupational Therapist Association of Thailand. Service database. [Internet]. Chiangmai (Thailand): The Occupational Therapist Association of Thailand. 2022 [cited 2022Sep.22]. https://www.otatthai.com/17535477/ฐานข้อมูลบริการ.
36. The National Health Security Office. NHSO Annual Report 2021. [Internet]. Bangkok (Thailand): The National Health Security Office. 2021 [cited 2022Sep.22]. https://eng.nhso.go.th/view/1/Annual_Reports/EN-US.
37. Badenoch JB, Rengasamy ER, Watson C, Jansen K, Chakraborty S, Sundaram RD, Hafeez D, Burchill E, Saini A, Thomas L, Cross B, Hunt CK, Conti I, Ralovska S, Hussain Z, Butler M, Pollak TA, Koychev I, Michael BD, Holling H, Nicholson TR, Rogers JP, Rooney AG. Persistent neuropsychiatric symptoms after COVID-19: a systematic review and meta-analysis. Brain Commun. 2021 Dec 17;4(1):fcab297. doi: 10.1093/braincomms/fcab297. PMID: 35169700; PMCID: PMC8833580.