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Mental Patients In Thailand To Be Released From Chains


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I remember once driving along the road and seeing this man sitting at the roadside with a rope or perhaps it was a chain attached to him, my friend beside me in the car explained that the man I guess he was 30-40 years old was a mental health sufferer and that the alternative would be for him to be locked in a room, as the family probably had no idea what else to do with him. Basically he reminded me of a young kid on one of these retractable child harnesses. He was allowed enough free rope/chain to go out from the house and garden and sit in the middle of the pavement, but he couldn't reach the road and go in front of road traffic thereby avoiding him being hit by a car.

Not ideal, but I did think it was a lot better to be able to sit out watching the world go by (albeit with a restricting rope/chain) and have people stopping to talk to him, rather than the alternative of being locked in a room that could probably better called a cell.

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I remember once driving along the road and seeing this man sitting at the roadside with a rope or perhaps it was a chain attached to him, my friend beside me in the car explained that the man I guess he was 30-40 years old was a mental health sufferer and that the alternative would be for him to be locked in a room, as the family probably had no idea what else to do with him. Basically he reminded me of a young kid on one of these retractable child harnesses. He was allowed enough free rope/chain to go out from the house and garden and sit in the middle of the pavement, but he couldn't reach the road and go in front of road traffic thereby avoiding him being hit by a car.

Not ideal, but I did think it was a lot better to be able to sit out watching the world go by (albeit with a restricting rope/chain) and have people stopping to talk to him, rather than the alternative of being locked in a room that could probably better called a cell.

It's very easy for us to moralise and pass judgment,whilst each case has it's own merits and issues and should be dealt with accordingly. But the bottom line is in this day and age people should be given better support to deal with these issues and for sure in no way is it acceptable that people feel that they have no alternative but to chain people up.

Edited by rijit
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Chains? What century is this? Surely any Thai national deseres better.

Is the western version of being kept in strait-jacket in a padded cell any better?

you dont use straight jackets in a padded cell,........ why would you ?

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They have fully qualified mental health professionals here in Thailand (see links in the health forum) both foreign and Thai. But really, how many foreigners even can afford them? There is some pro bono work done by grad students and trainees, but it is very limited and location-specific (mostly Bangkok). Seems highly unlikely that 'appropriate treatment' is really in the future of any of those patients, but if there is some less demeaning way to keep them from harming themselves or others, some government involvement could be helpful. Seems like this is well-intentioned, anyway.

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Chains? What century is this? Surely any Thai national deseres better.

Is the western version of being kept in strait-jacket in a padded cell any better?

you dont use straight jackets in a padded cell,........ why would you ?

yeah and In fact strait jackets arn't used ,if they really are in danger of doing serious harm to themselves or anyone else it's reckoned to be far better and loads easier to sedate them.

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Typical of many Thai Visa posters, trivialising a very serious problem. I'll bet all of you wha think this subject is funny, good for a laugh, taunt or joke, would not have such a smirk on your face if it were a relative or close friend that suffered from such a condition.

Probably the same type of person that would laugh at a person with a neuromuscular disability or that would dump their relative in such a facility and never look back.

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Chains? What century is this? Surely any Thai national deseres better.

Is the western version of being kept in strait-jacket in a padded cell any better?

Read the article again dont just twist it into a racial issue, if you have racial issue's perhaps you need to talk to someone about them.

and yes the stuctured use of a straight jacket, and a padded cell would be far preferably to chains

and can i add that straight jackets, these days, in the UK, i wouldn't say never used, but are v v seldom used.

It's a racial issue to mention strait-jacket and padded cells used in some countries? Gosh, must have hit a nerve with you.

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Chains? What century is this? Surely any Thai national deseres better.

Is the western version of being kept in strait-jacket in a padded cell any better?

you dont use straight jackets in a padded cell,........ why would you ?

Use of hands to hurt yourself.

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They have fully qualified mental health professionals here in Thailand (see links in the health forum) both foreign and Thai. But really, how many foreigners even can afford them? There is some pro bono work done by grad students and trainees, but it is very limited and location-specific (mostly Bangkok). Seems highly unlikely that 'appropriate treatment' is really in the future of any of those patients, but if there is some less demeaning way to keep them from harming themselves or others, some government involvement could be helpful. Seems like this is well-intentioned, anyway.

The number of mental health professionals has been discussed in the past. Thailand has an inadequate number of psychiatrists and psychologists such that the burden of care falls upon social workers who while well intentioned, do not have the training and education necessary to manage the large number of patients.

There is a worldwide shortage of personnel trained in geriatric mental health care, with Thailand having almost no one. With an aging population and growing numbers of patients afflicted with age related dementia, there is a health care crisis.

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I remember once driving along the road and seeing this man sitting at the roadside with a rope or perhaps it was a chain attached to him, my friend beside me in the car explained that the man I guess he was 30-40 years old was a mental health sufferer and that the alternative would be for him to be locked in a room, as the family probably had no idea what else to do with him. Basically he reminded me of a young kid on one of these retractable child harnesses. He was allowed enough free rope/chain to go out from the house and garden and sit in the middle of the pavement, but he couldn't reach the road and go in front of road traffic thereby avoiding him being hit by a car.

Not ideal, but I did think it was a lot better to be able to sit out watching the world go by (albeit with a restricting rope/chain) and have people stopping to talk to him, rather than the alternative of being locked in a room that could probably better called a cell.

It's very easy for us to moralise and pass judgment,whilst each case has it's own merits and issues and should be dealt with accordingly. But the bottom line is in this day and age people should be given better support to deal with these issues and for sure in no way is it acceptable that people feel that they have no alternative but to chain people up.

I know what you are saying, but I have never ever came across a country where people have their emotions restricted by this so called "Kreng Jai". They spend their lives repressed, cannot express distaste or anger in everyday life - it must be like living in a pressure cooker!

Then, probably one day it just gets too much - then they EXPLODE - and commit terrible devastation.

We farangs don't get this kind of presssure, if we did I suspect we too would boil over. We seem in our society to be able to have a <Snip> big bust up, get over it and patch things up - These Thais will hold a grudge for a thousand years!

It is all down to education, I truly believe if they were given a chance they would actually behave like everyone in an educated society. Yes nothing is perfect, there are nutcases everywhere, but the Thais cannot even protest against a simple mistake if the person that made the mistake "assumes" a higher pecking order - they simply walk away with their tails between their legs rather than sort things out. They probably go home and cast some sort of "Voodoo" on the offender rather than have a confrontaition. It seems crazy, maybe it is, maybe it isn't, but for me I like to clear the air and give a second chance.

Look at Columbine! They were Westerners -and that was pretty dam_n mad! So we are all capable of doing it - look at every war in the west! Look at the stupidity that is brewing now in Israel and the UK and USA against Iran!

Look at the crazy behaviour of elected politicians a few years back in Iraq! They lynched the very guy they sold the weapons too, they flogged Saddam poisons, Anthrax (The USA) used spy satellites to pinpoint positions (They - the Isrtaelis - fed co-ordinates to both sides as to where the troops were positioned - They had already put a hack in their software that they sold them) in Iran and Iraq, fed both sides the information until they killed as many of both armies as they could!

Look at that disgusting piece of FILTH Henry Kissinger - that antichrisht should have been put to death at birth, he was the one who advised America to support both Iran and Iraq at the same time during their war! What a piece of dirt that is barely human!

Edited by billybobthedog
Disguised profanity removed.
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Oh my;

Look at that disgusting piece of FILTH Henry Kissinger - that antichrisht should have been put to death at birth,

When I read phrasing like this, I also hear little bells that go ting tong, ting tong. Let's see what we have here; a strongly worded opinion harmless in itself, but then it veers off onto wackoland with, a reference to the book of Revelations and then a demand for killing an infant. Oh yes, that certainly belongs in a mental health thread. As we can see, perhaps the Thai approach is needed for some foreign guests advocating killing infants. And the missu wonders why I am so aloof with foreigners. LOL

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They have fully qualified mental health professionals here in Thailand (see links in the health forum) both foreign and Thai. But really, how many foreigners even can afford them? There is some pro bono work done by grad students and trainees, but it is very limited and location-specific (mostly Bangkok). Seems highly unlikely that 'appropriate treatment' is really in the future of any of those patients, but if there is some less demeaning way to keep them from harming themselves or others, some government involvement could be helpful. Seems like this is well-intentioned, anyway.

The number of mental health professionals has been discussed in the past. Thailand has an inadequate number of psychiatrists and psychologists such that the burden of care falls upon social workers who while well intentioned, do not have the training and education necessary to manage the large number of patients.

There is a worldwide shortage of personnel trained in geriatric mental health care, with Thailand having almost no one. With an aging population and growing numbers of patients afflicted with age related dementia, there is a health care crisis.

The shit will hit the fan, if "the health professionals" turn out to have a lower "intelligence" than all the mentally sick people in the Land of Why? jap.gif

Edited by sirchai
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and can i add that straight jackets, these days, in the UK, i wouldn't say never used, but are v v seldom used.

What people think are staright jackets are certainly not used at all in Mental Health Services in the UK. They haven't been for many years. However, within the HMP Service, there is a restraint called a "Body Belt", this is not like the old straight jacket of yesteryear, and is a reinforced belt, covered in leather with cuffs on it. Permission to use these are seldom given. Within the hospital system, Seclusion is used to contain patients who may have become unmanageable, and again this is not something done lightly. There are no Padded Cells these days either. Most restraint is now administered IM, with a combination of certain medications - although this may require staff to initially contain a patient using Control & Restraint, before being relocated to seclusion, or a safer area.

There's a long way to go in terms of improving Psychiatric care in Thailand for the majority.

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They have fully qualified mental health professionals here in Thailand (see links in the health forum) both foreign and Thai. But really, how many foreigners even can afford them? There is some pro bono work done by grad students and trainees, but it is very limited and location-specific (mostly Bangkok). Seems highly unlikely that 'appropriate treatment' is really in the future of any of those patients, but if there is some less demeaning way to keep them from harming themselves or others, some government involvement could be helpful. Seems like this is well-intentioned, anyway.

The number of mental health professionals has been discussed in the past. Thailand has an inadequate number of psychiatrists and psychologists such that the burden of care falls upon social workers who while well intentioned, do not have the training and education necessary to manage the large number of patients.

There is a worldwide shortage of personnel trained in geriatric mental health care, with Thailand having almost no one. With an aging population and growing numbers of patients afflicted with age related dementia, there is a health care crisis.

Agreed. Very limited number of Psychiatrists, Psychologists, Psychiatric Nurses and properly trained Psychiatric Social Workers.

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A program doomed to fail. There are not enough mental health professionals in the country to provide even rudimentary care.

It is wrong to chain patients, but I fear the outcome may be much much worse if the patients are unshackled and left unsupervised.

Damned if you and damned if you don't.

This is the 21st century and this 5th world country is still employing primitive practices that developed countries abandoned way more than a 100 years ago.

God Save Us

While no one would fail to condemn keeping mental patients in chains, at times one must wonder about the levels of condescension in this forum. To refresh our memories, here are some bits detailing the "advanced" practices of the "developed" countries from way less than one hundred years ago:

1932 - Sakel introduced insulin coma therapy as a treatment for schizophrenia. Also used to treat morphine withdrawal.

1934 - Electroconvulsive therapy (ECT) introduced by von Meduna, a Hungarian physician, using intramuscular injections of camphor. It did not reliably produce seizures, which he believed could ease schizophrenia.

1935 - Moniz performed the first leukotomy on a female patient by destroying the fibers connecting the frontal lobes to the rest of the brain. Her agitation and paranoia diminished, but successive patients only seemed dull and apathetic. Still, when he published his work, it was swiftly put into practice.

1938 - After visiting a slaughterhouse and seeing animals knocked out by electric shock, Cerletti and Bini introduced electrically produced seizures. Inadequate anesthesia sometimes resulted in bone fractures, and patients complained of memory loss, and the process is considered more effective in treating depression than schizophrenia.

1948 - Using an ice pick and a hammer, neurosurgeon Walter Freeman performed a lobotomy on 34-year-old Frances Farmer, actress and political activist, after all other treatments failed to subdue her communist leanings and aggression. She became mediocre and slow after the surgery, ending her days as a hotel clerk. She died of cancer in 1970.

1978 - Italy passes legislation closing the doors of all psychiatric institutions to new admissions. Diagnoses of schizophrenia virtually disappear: in the following four years, one case is diagnosed in the region of Verona, pop. 90,000.

1992 - A survey of American jails reports that 7.2 percent of inmates are overtly and seriously mentally ill, meaning that 100,000 seriously mentally ill people have been incarcerated. Over a quarter of them are held without charges, often awaiting a bed in a psychiatric hospital.

2001 - Robert Whitaker publishes Mad In America, a thoroughly-researched indictment of treatment of the mentally ill in America.

http://laingsociety.org/cetera/timeline.htm

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GK- I think we are in agreement, I'm just looking at it from the price end- those that Thailand has can do a lot better than the train-wreck 'for-the-public-good' cases the article is talking about. How many farmer relatives would have to chip in for those costs? It's just not going to happen. Of course, even if they did somehow have the money, you're right there aren't enough people to help all the mentally ill- here or almost anywhere else!!!

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Thai rak Thai,- don't they? And how about the guys beating up their kids and their wifes as it happens right in front of my house at least once a week?

And please don't blame it on me for living in a typical Thai neighborhood!

Edited by TackyToo
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Another good reason amongst numerous as to why should one NOT LIVE IN HORRIBLE SINGAPORE ...!! Eesshh ..hate the place!!

Mental patients in Singapore are put to death if they try to commit suicide??

I think you will find that is total nonsense.

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"The most common type of mental illness suffered by 70 percent of Thais with a mental disorder is Schizophrenia." Is that 70% of the poulation? If so it seems a bit on the low side!

That will be 70% of the patients with diagnosed mental disorder, I understand. I don't think it's low, but I don't have comparisons to other countries. Would you like to share?

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A program doomed to fail. There are not enough mental health professionals in the country to provide even rudimentary care.

It is wrong to chain patients, but I fear the outcome may be much much worse if the patients are unshackled and left unsupervised.

Damned if you and damned if you don't.

This is the 21st century and this 5th world country is still employing primitive practices that developed countries abandoned way more than a 100 years ago.

God Save Us

There is no 5th world - at least I am not aware of it. Please send a link to the definition.

And yes, these techniques were abandoned in other countries a long time ago, so it is good that they finally do something over here. An exceptionally clear plan, even with time frames, I'd say. Kudos to the minister, and let's hope everything goes smoothly as planned.

God has nothing to do with this.

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Just make sure they're given plenty of 100% legal & toxic prescription pills and they will be fine. Don't give them any non-toxic herbs which grow naturally out of the earth because Dupont, Pfizer, etc., will not be happy and might cause their profits to dwindle. Remember, the gigantic drug companies need to have their money before a patient here in the Kingdom of Thailand can attain proper treatment that will actually improve their mental health without poisoning the patient.

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I'd like to tell you about a completely personal experience that might in some way reflect Thai values and reactions to this kind of problem.

My wife's young cousin suffered from severe epilepsy, at times up to 6 seizures a day. He was effectively a foundling in the family because his mother became seriously schizophrenic soon after his birth, so he was raised by female relatives with little contact with his father or siblings.

Soon after I came here the family decided that the best thing that could be done for the young man was for him to enter the monkhood in a temple where traditional Thai medicine was practised; as a newcomer I offered no opinion on this since I know nothing about those kinds of therapies.

However soon after his entry to the monkhood it became clear that what the family were hoping for was not happening; he became delusional believing that he had been invaded by the spirit of an ancient warrior king.

Instead of accepting that this was either epileptic psychosis or schizophrenia, the family appeared to take it at face value and the response was to accept the advice of what I would call a "shaman" whose answer was to sacrifice a buffalo and the intruding spirit would go with the buffalo's spirit. I did my best to explain about epileptic psychosis and schizophrenia and that his epilepsy and the research which suggests that there may be a genetic/inherited predisposition towards schizophrenia meant he was in a category with higher than normal likelihood of displaying these symptoms but whether I made myself understood sufficiently or whether my Western values were dismissed, they went ahead with the buffalo idea.

He didn't get any better and was passed around the family for a while until recently when he was living on his own on land where an uncle is building a house, the idea being that he could work on the site and for company there were friends living nearby. I didn't know this and thought that he was living on a farm with another uncle until 3 weeks ago when he was taken to hospital having chopped off the index finger of his left hand. I was appalled that he had been on his own when this happened but it gets worse.

A week later we received news that he was missing from the uncle's property - yes he had been taken back there to live on his own again. His body was found in the 3-metre deep fish pond on the site.

Thais, at least in my family, don't understand mental illness; the spirit world means something to them that doesn't exist in Western cuture.

Edited by pastitche
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