Dr. Amporn, Dr. Opas, Dr. Pongsadhorn,
Distinguished experts, colleagues and friends,
I am honored to address you all about strengthening community mental health in the post-Covid era.
The importance of mental health for general wellbeing, inclusion and prosperity is reflected in the priorities of APEC and delivering on mental health objectives across the region will also be key to achieving SDG 3.
This workshop is a good opportunity to bring experts and stakeholders together from across countries to work out solutions in the delivery of mental health services through community-based initiatives.
Poor mental health remains a serious global concern, especially because it can stay invisible by being left undiagnosed and untreated.
Depression is a leading causes of disability worldwide while suicide is the fourth leading cause of death among 15- to 29-year-olds, according to WHO.
People with severe mental health conditions often die prematurely due to preventable physical conditions. Their lifespan is often shortened by as much as two decades.
In Thailand too mental health disorders are taking their toll.
In a recent online survey last year by the Department of Mental Health of over 2.3 million people nationwide one of 10 respondents reported suffering from depression.
Some 5.5% of respondents said they were feeling suicidal at times. This is very concerning because many of them follow through on these thoughts.
Even more disconcerting is that many children and adolescents also suffer from mental health problems.
In a UNICEF-led survey last year, 1 in 7 teenagers and 1 in 14 children under 9 reported having mental health disorders.
This problem is more pronounced among girls than boys, highlighting a gender disparity in mental health with different behavioral manifestations.
Anxiety, depression and suicidal ideation are common among youth as are substance and alcohol abuse. Suicide is already the third leading cause of death among adolescents in the country.
However, Thailand is well placed to handle these challenges.
Thanks to its universal healthcare scheme and robust healthcare system, the country has made admirable progress in addressing all manner of healthcare-related challenges.
This was amply demonstrated during the pandemic when Thailand became a global success story in containing the outbreak through mass vaccination and other interventions.
However, the pandemic also worsened general health outcomes nationwide, including adverse impacts on mental health.
Thailand has a dedicated mental health program under the Ministry of Public Health while mental health services are well integrated into primary care and the community-level health system.
Community mental health covers the needs of people across their lifespan and a comprehensive mental health law includes patients’ rights.
We can leverage these strengths to extend mental health provision even further by expanding community-based treatments and rehabilitation in collaboration with local authorities and the 1 million health volunteers.
The WHO is calling for a strategic shift in the delivery of mental health services from hospitals to community-based systems to increase access, engage families better and lessen stigmas on mental disorders.
Between 2014 and 2020 inpatient admissions decreased sharply from nearly 5,500 to just over 1,500 per 100,000 people while community-based mental health services increased from 0.003 to 1.74 per 100,000.
By expanding community-based mental health services even further, we can achieve even greater results.
However, that will require spending more on mental health.
Currently, annual spending amounts to around 2.3% of overall health expenditure, but far more is required, especially because over 80% of funding goes to mental hospitals.
There is a shortage of trained mental health professionals nationwide. Thailand has only 203 psychiatrists, 187 psychologists and 1,907 mental health nurses, based on the latest figures by WHO.
To help fill those gaps in capacity, UNICEF is supporting the Government in developing a costed integrated mental health and psychosocial support plan for children and adolescents.
The UN agency is also supporting children and young people to cope with mental health challenges by raising awareness and it is equipping parents, caregivers, and teachers with tools to help children build their resilience for mental wellbeing.
We also have to expand outreach to the most vulnerable, including migrants and people with disabilities.
In a pilot UNHCR, together with the government, is training volunteers among refugees in camps to protect and promote residents’ mental health and psychosocial wellbeing.
We have also been engaging with youth with disabilities in the context of mental health. An important part of our advocacy targets removing stigmas on mental health disorders.
The UN, in partnership with the private sector, has been raising awareness over the past month about young people’s mental health challenges via large digital billboards in major cities from Chiang Mai to Bangkok to Songkhla.
This way we can potentially reach millions of people for these messages.
In closing, I would like to emphasize that we need a paradigm shift on mental health.
The government will need to prioritize mental health services for people of all ages, backed by adequate resources, urgent capacity building and the scaling up of digital solutions.
We will also need to leverage community engagement better for improved mental health service provision to leave no one behind.
This workshop is a great opportunity for us to hear perspectives from across countries to draw insights for informing policies and implementing community-based mental health services.
I am looking forward to all the fruitful discussions.