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The Experiences of the Department of Mental Health, Thailand
in helping the survivors from the Tsunami Disaster
ByDr.Wachira Pengjuntr, M.D.
Deputy Director GeneralDepartment of Mental Health
Ministry of Public Health, Thailand
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Health Care System in ThailandOffice of the Permanent SecretariatOffice of the Permanent Secretariat
The Permanent Secretariat
The Local Administration
Provincial Public Health OfficeHead Of the Provincial Public Health Office
District Public Health OfficeHead of the District Public Health Office
Provincial Hospitals/General Hospitals (93)
Community Hospitals (716)
Health Office (4,000+)
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Mental Health Services System
Ministry of Public Health
Ministry of Defense Hospitals
Ministry of Interior Hospitals
Bangkok Metropolitan Hospitals
University Hospitals
Private Hospitals and Clinics
People with mental problemsPsychiatric patients
Tertiary CarePsychiatric Hosp.(17)
Secondary CareGeneral Hosp.
Primary CareComm. Hosp./ Health Center
Dept. of Mental Health
Office of PermanentSecretaryMOPH
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Management of patients with mental disorders
Psychiatric Hosp.Both
Primary & Secondary Care setting
78%
13% 9%
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The Roles and Responsibilities of The Department of Mental Health
During the Emergency Phase
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Established the Mental Health Center for Thai Tsunami Disaster ( MHCT)at The Department of Mental Health, Ministry of Public Health,
Nonthaburi Province
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Department of Mental Health
Mental Health Center for Thai Tsunami Disaster
The mobile teamsin the 6 provinces
Suan Saranrom PsychiatricHospital in Surat thani
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A Teleconference Room at the MHCT
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Set up Mental Health Mobile TeamsEach team consists of 10 personnel1 Psychiatrist2-3 Psychologists1 Social Worker2 Psychiatric Nurses1 Pharmacist1 Assistant Nurse1 Driver
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The Responsibilities of the Mobile Teams
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The Roles and Responsibilities of The Department of Mental Health
During the Post Impact Phase
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New Concept
• From Providers to Facilitators• From Victims to Survivors• From Function Oriented to Area
Oriented• From Individual to Family and
Community
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Deliver psychoeducation through various mediavarious media
Website MHCT @ http://Website MHCT @ http://www.dmh.go.th/dmhmcc/dmh_tsunamiwww.dmh.go.th/dmhmcc/dmh_tsunami//
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Public Education
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Training health personnel and volunteers
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Training the Volunteers
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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
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Organized the workshop and conferences
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Post Tsunami Mental Health Assessment(8th weeks post-disaster)
From DMH & TUC
Displaced%
CommunityPhang Nga
Community Krabi/Phuket
Severe PTSD
Mod. PTSD12.115.4
6.811.2
3.06.2
Adult :
Children :Displaced
%Community
Phang Nga/ Krabi/PhuketSevere PTSD
Mod.PTSD13.331.6
8.128.3
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The Roles and Responsibilities of The Department of Mental Health
During the Recovery Phase
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Strengthening the network in the community for the continuous and permanent recovery
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The meeting at the Center of Public Health Surveillance and Relief After Tsunami Disaster
In the six southern provinces of Thailand
Plans of the Intervention and Rehabilitation for the Tsunami survivors (2005-2006)
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Guideline to Follow Up and Rehabilitation2 months – 2 years period after the Tsunami Disaster
Promote Community Actions
Home visit/ Community Health Status Assessment
At Risk ?Basic
Counseling
Refer to Provincial/General Hosp./Comm. Hosp.
1 Year Follow up? Treatment Follow up
Psychiatric Team
Health Center/Community
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N
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YY
H.C./Community
Comm./Gen.Hosp.
Provincial/Psychiatric Hosp.
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Treat by medicine & Counseling
Guideline for Primary Care and Referring SystemGuideline for Primary Care and Referring SystemPatients Admission from The Community
Screening
Diagnosis
Patients with Severe Symptom
Psychiatric Team
Basic Basic CounselingCounseling
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N
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Comm./Gen.Hosp.
Nurses
Medical Doctor
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Doctor + Nurse
Doctor
Provincial/Psychiatric Hosp.
1 Year Follow upDoctor + Nurse
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- 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, Suicideand Drug Abuse
- Research study- Database and report system development
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Mental Health Recovery Center
ศูนยฟนฟูสุขภาพจิต กรมสขุภาพจิต
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Thank you