ASSESSMENT OF CONCERNS IN
MENTAL HEALTH PROMOTION

BACKGROUND: CONCERNS ABOUT
MENTAL HEALTH IN EASTERN THAILAND

Eastern Thailand is experiencing rapid change toward an industrial economy, and transition brings with it changes in lifestyle and life choices for most of the young population. Change and uncertainty are sources of emotional and mental distress, yet people native to the region, as well as the influx of immigrants, temporary workers, and visitors must find ways to adapt and integrate themselves into a new milieu, usually without the benefit of traditional wisdom. It is probable that many are also distanced from traditional support systems such as family or neighborhood. Thus, we suspect that many people are exposed to experiences which their traditional advisors are not familiar with. Another problem is that people may not have developed coping skills adequate for the new environment.

Many hypotheses are made regarding the adaptations and ability of people to adapt to changing environment. "Survival traits" such as socialization choices, help seeking behaviors, adaptive coping, or job seeking need to be observed as well as traditional indicators of problems such as school/work attendance, alcoholism, suicide rates, reckless driving, abusive behavior, or disengagement form society. Environmental factors that serve as triggers for personal disintegration, or that cause personal stress or encourage maladaptive behaviors or uncontolled risk taking, including homelessness, disparities in care and opportunities, living with chronic conditions or STD's, or catastrophic loss need to be assessed. Social control and political factors also both define and promote mental health. Example indicators of the social and political environment might be acceptance of criminal behaviors, delinquency, or service utilization characteristics.

The Department of Mental Health of the Thai Ministry of Public Health (DMH) has described the mental health burdens for the country, as well as dealing with the specific mental disorders and problems such as suicide, and drug and alcohol misuse. The DMH indicates that situations which impact mental health include social level indicators such as demographic structures including migrations and disabilities, economic situations, education, and communication. The DMH also uses as indicators of mental concerns the family level variables which describe family structures, stresses, or problems of children. At the individual level, the DMH considers the diagnosis, treatment and prevention efforts as well as collecting data on healthy leisure behaviors, and unhealthy behaviors such as drinking alcohol, smoking and sexual conduct leading to STD's.