Majority of people in Thailand have been so proud of the way our country has handled #covid19, and although credit is due where it’s deserved, there is a large issue at hand that we need to address: Mental Health. My sister (thanks Didi! To read her blog post on the issue entitled Strengthening Connections for At-Risk Women and Children during COVID-19, click here) sent me a link from NPR entitled The Cost Of Thailand’s Coronavirus Success: Despair … And Suicide, and this post will be taking excerpts from this article as I believe it is so important to address this.

“The case and death rates from COVID-19 in Thailand are among the world’s lowest, with about 3,100 confirmed cases and 58 deaths, as of Thursday (June 11th). Thai epidemiologists say their health care system — one of the finest in the world — had a major role to play. So did a strict lockdown.”

As someone who works in healthcare in Thailand, this part of the article truly does make me proud. Our medical system has never been overwhelmed as a result of covid19. This is because we are a medical tourism hub, so we always have enough beds for Thai citizens, residents, and foreigners that fly in for care and treatments. Also it is definitely true that the quickly enforced lockdown with a curfew plays a part in the success. The government shut the airports without much notice, which prohibited non-citizens to fly in. The day the lockdown happened I had several calls and messages from my colleagues and friends in neighboring countries asking if there is any way we could arrange an air ambulance or emergency flight for them to come to Bangkok because everyone knows that this is a great place to be if you need medical attention. Unfortunately for them, they had to stay where they were as our country was reserving our resources for our people.

Although covid19 was managed well, it is sadly true that “the measures to contain the virus have also caused mass disruptions as the economy came to a sudden stop. In Thailand, many of the economy’s most crucial sectors have been severely restricted by the lockdown. Construction sites, offices and massage parlors were shut down. Tourism, which makes up 20 percent of the national GDP, collapsed as international borders closed and airlines were grounded. Manufacturing makes up another 30 percent of GDP; factories were shuttered for the lockdown, and exports will struggle to rebound as global trade remains uncertain … To offset the economic hardship from the lockdown, the government launched a financial aid program in March that disburses 5,000 baht, or $150, a month for three months to people whose incomes have been affected. Nearly 29 million Thais applied. After several expansions of the fund, by mid-May, about 16 million had started receiving the monthly stipend or were close to getting it. But the delays and rejections have left some in desperation. In April, a woman drank rat poison outside the Ministry of Finance to protest the long application process to receive the 5,000 baht aid. She survived. A man who picketed to protest outside the ministry died by suicide four days later.”

Financial stress is real, and it can lead to mental health problems. There are millions of daily wage workers in Thailand, and as a result of covid19, these people were all out of jobs. In simple terms, this means they could not earn to feed their families.

This is why “Dr. Varoth Chotpitayasunondh, a psychiatrist and spokesperson for the mental health department of Thailand’s Ministry of Public Health, says that now the threat of COVID-19 is under control, the government is faced with a different public health challenge: “The next wave of the problem will be mental health.

Somchai Preechasilpakul, an associate professor of law at Chiang Mai University who researches the impact of government policies on the urban poor, criticized the government response for its slow disbursement – while some received the aid within a couple of weeks, others were left waiting for a month or more — and the uncertainty around who would qualify for the aid and who wouldn’t. A system that automatically distributed the 5,000 baht aid to Thai workers (and allowed those who didn’t need it to opt out), Preechasilpakul said, would have allowed more people to receive the aid more quickly. Instead, the existing system tangled millions in bureaucratic red tape, even as their bills piled up and some struggled to afford their next meals. Delays and rejections heaped stress upon uncertainty for Thailand’s poorest. He said the coronavirus response has not succeeded if people are dying by suicide. “It’s a failure of the system,” Preechasilpakul said. Preechasilpakul is a part of research team that published a report at the end of April that found that of the more than 80 suicide attempts they reviewed in April, 44 were related to hardships caused by the economic lockdown.”

I completely agree with Khun Preechasilpakul and sympathize with those affected, especially after reading this anecdote: “Apinya Thamniyon, 53, a taxi driver, sat, weary and hunched into his light blue uniform, his loose black trousers gathered around his waist. The day before, the landlord threatened his wife with eviction because they were two months behind on their rent. If he misses another payment on his taxi, that, too, will be taken away. With the city at a near standstill, he was making as little as 150 baht ($4.70) a day — far less than what he needed to cover gas, the taxi rental and basic expenses — and some days nothing at all. Before the lockdown, he could expect to make as much as 1,000 baht ($31) a day. He found out that day that his application was canceled, with no explanation, and was told to reapply.

Thailand controlled the spread of coronavirus in part because of a vast network of over 1 million village health volunteers, who went door to door, checking temperatures, dispensing public health advisories and dispelling misinformation. At night, they sewed masks and, in the mornings, distributed them to their neighbors. Now, says Varoth Chotpitayasunondh, of the mental health department, the same volunteers will get basic training to recognize stress, burnout and anxiety in their neighbors. If one of their neighbors is exhibiting signs of possible depression or dangerous suicide ideation, they will refer them to mental health nurses, social workers or the local psychiatrist, there’s at least one in each of Thailand’s provinces.

The mental health department launched a program in May to help Thai people navigate the mental health crisis. It includes a prevention plan it called the “mind vaccine,” meant to provide guidelines for communities to build mental resilience and find ways to tailor activities to their community’s challenges.

Effective approaches and activities, Chotpitayasunondh emphasized, will be different in each community in Thailand, but the program sends the message that the mental health crisis is real, and it should be faced head-on.”

I request everyone who reads this post to acknowledge that mental health is a real issue, and to take action by checking in on your loved ones including friends, family, and staff. Those that are suffering with their mental health may not know how to ask for help, so do your part by staying connected and offering support to anyone and everyone that you can.

Information Compiled by and Opinions of Devi Bajaj
Founder & Director of Enliven Health Concierge

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