Mental Health In Thailand.

[younghusband]

What is missing in this thread, picking up on a point made by Guesthouse, is advice whether there is are psychiatrists in Thailand who can not just speak English but can actually make a cultural connection with farangs who have mental health problems.My quite strong feeling is that this would only include Thais who had practised for long periods of time in N.America, Australasia or the UK.Possibly there are competent farang psychiatrists here.It would be useful to know.

[sobe]

Never said stay away from D.'s said stay away from psychiatrist's and the drugs they so freely pas out and the ridicules perform EC (electroconvulsive therapy they routinely preform ... I think the profession is dangerous.

Psychologist on the other hand primarily aids the depressed patient by counseling and psychotherapy , diet and exercise much safer and more effective in getting results . Again never said the person who started the thread should stay away from Dr,'s . just suggested diet and exercise much safer and more effective forms of dealing with psychological problems .

As far as a top Psychologist educated in the US and and who speaks english email American psychologist Ben Weinstein lives in Bangkok, Dr. Weinstein teamed up with Thai psychologists and mental health professionals in the Thai Department of Mental Health to treat patients and train other psychologists, social workers, educators, health-care professionals and community volunteers after the tsunami disaster and stayed and is practicing in Bangkok.

[email protected]

Edited October 21, 2006 by sobe

[younghusband]

Never said stay away from D.'s said stay away from psychiatrist's and the drugs they so freely pas out and the ridicules perform EC (electroconvulsive therapy they routinely preform ... I think the profession is dangerous.

Psychologist on the other hand primarily aids the depressed patient by counseling and psychotherapy , diet and exercise much safer and more effective in getting results . Again never said the person who started the thread should stay away from Dr,'s . just suggested diet and exercise much safer and more effective forms of dealing with psychological problems .

As far as a top Psychologist educated in the US and and who speaks english email American psychologist Ben Weinstein lives in Bangkok, Dr. Weinstein teamed up with Thai psychologists and mental health professionals in the Thai Department of Mental Health to treat patients and train other psychologists, social workers, educators, health-care professionals and community volunteers after the tsunami disaster and stayed and is practicing in Bangkok.

[email protected]

This is pure nonsense.Psychiatry and appropriate medication has a vital role.I have personally seen how miserable existences have been transformed for the better by the psychiatric profession.

I checked out Dr Weinstein's website.I have no reason to believe he's not reputable but the site is amateurish, no details of professional qualifications for example.

[Sheryl]

What is missing in this thread, picking up on a point made by Guesthouse, is advice whether there is are psychiatrists in Thailand who can not just speak English but can actually make a cultural connection with farangs who have mental health problems.My quite strong feeling is that this would only include Thais who had practised for long periods of time in N.America, Australasia or the UK.Possibly there are competent farang psychiatrists here.It would be useful to know.

YES. ThereARE. I have tried to make this point on this thread before. Samitivej has a large psychiatric department with more than 20 English-speaking doctors on staff, many of them trained in the West and board certified there; several maintain current appointments at hospitals in the US and/or UK. Check out the doctor search function on their website fior details of the qualifications of various doctors.

While I have, and no doubt will in future, given out plenty of advise on this forum I agree with Sri Racha John as regards this particular poster. The symptoms described are potentially very serious and need professional evaluation.

[sriracha john]

While I have, and no doubt will in future, given out plenty of advise on this forum I agree with Sri Racha John as regards this particular poster. The symptoms described are potentially very serious and need professional evaluation.

Thank you for recognizing that each individual thread is unique. In this particular thread, what I and you advocate is the best course to follow. What some others have advocated is downright reckless, irresponsible, and potentially lethal. It illustrates the fundamental lack of understanding as to the seriousness that depression can represent.

Once again, I wish all the best to the OP and hope that he is able to obtain the proper help he needs.

Edited October 22, 2006 by sriracha john

[Ijustwannateach]

I'd also like to advise that anything read here can only serve as very uninformed opinion- few (if any) of us are doctors or have medical training, and even if we were none of us has actually met or performed any diagnostic procedures on the OP. The OP seems sensible enough to understand this, but just to make sure: none of this advice constitutes a real, professional medical opinion. Please get the help of qualified experts.

"Steven"

[Bud1000]

I'd also like to advise that anything read here can only serve as very uninformed opinion- few (if any) of us are doctors or have medical training, and even if we were none of us has actually met or performed any diagnostic procedures on the OP. The OP seems sensible enough to understand this, but just to make sure: none of this advice constitutes a real, professional medical opinion. Please get the help of qualified experts.

"Steven"

Great post

[Mr Jones]

now the poor fella is sick of Thai food

[baboon]

now the poor fella is sick of Thai food

Yes, but I mean what I say. Not liking Thai food anymore is not a reflection on the Country. It is a statement of fact. Please flame someone else. I really dont need it now.

[Mr Jones]

sorry bro but I WAS NOT flaming you

going off your food is just another sign opf your Depression

Lez

[Ijustwannateach]

I think we are beginning to drift off-topic here. Sobe, I'm sure you mean well, but this thread is for the specific question of the OP's problem. If you want to discuss psychiatric treatment in general, may I suggest you start an independent thread in this subforum so that the OP's concern doesn't get lost in a debate- thanks.

"Steven"

[sriracha john]

Thanks, IJWT.

While reading the previous post, I was debating whether or not to answer the off-topic rubbish with extensive factual data or just decide to let it go as it was so completely inaccurate, recklessly dangerous, and off-topic.

Thanks for helping me to decide.

[AmeriThai]

There was an article in the Bangkok post just about a year ago saying that Thailand needs about 750 more psychiatrists. I forget the ratio but I think it was 1 for every 1000+ people in Thailand. The case load they have is staggering.

1 psychiatrist for every 1000+ people in Thailand? Figuring the population is about 60 million, that would suggest there are around 60,000 psychiatrists in Thailand. How accurate is that estimate? Sounds a bit on the high side to me.

[John K]

There was an article in the Bangkok post just about a year ago saying that Thailand needs about 750 more psychiatrists. I forget the ratio but I think it was 1 for every 1000+ people in Thailand. The case load they have is staggering.

1 psychiatrist for every 1000+ people in Thailand? Figuring the population is about 60 million, that would suggest there are around 60,000 psychiatrists in Thailand. How accurate is that estimate? Sounds a bit on the high side to me.

It was a while ago and I don’t remember exactly but the comment ‘need 750 more’ sticks out in my mind. It could have been a ratio for people with mental health. Bits and pieces it does not pay as well as non mental health doctors. If there are archives available I think is was September last year, and it was the headline of that particular day.

[Sheryl]

To say that antidepressants and antipsychotics are always useless and/or harmful is just as silly as to say that they are always the answer.

These are potent drugs which, like all pharmeceuticals, have a range of efficacy and side effects. Properly used (right choice of drug and dosage specific to the nature of the problem) they can be highly effective for those people whose condition warrents it. Used improperly or unnecssarily, they will cause problems.

Same could be said of any class of drugs.

Owing to the subjective nature of the symptoms involved, there probably are more mistakes made with pyschotropic drugs than other presecriptions, and indeed some doctors do over prescribe them and/or prescribe the wrong type of drug, making matters worse. This in no way alters the fact that there are people who need these drugs and will benefit greatly if treated with them in a proper manner.

I am a health professional but having never met the OP and without the benefit of a lot of evaluative test resuklts (most of which it sounds like have yet to be done) I cannot remotely say whether or not he would benefit from any medication, let alone which type. What I can say is that his symptoms are serious and require detailed evaluation in a clinical setting in order to rule out possible physical causes and determine the exact nature of the problem so that appropriate therapy can be instituted. The sooner the better.

[Pattayatony]

To say that antidepressants and antipsychotics are always useless and/or harmful is just as silly as to say that they are always the answer.

These are potent drugs which, like all pharmeceuticals, have a range of efficacy and side effects. Properly used (right choice of drug and dosage specific to the nature of the problem) they can be highly effective for those people whose condition warrents it. Used improperly or unnecssarily, they will cause problems.

Same could be said of any class of drugs.

Owing to the subjective nature of the symptoms involved, there probably are more mistakes made with pyschotropic drugs than other presecriptions, and indeed some doctors do over prescribe them and/or prescribe the wrong type of drug, making matters worse. This in no way alters the fact that there are people who need these drugs and will benefit greatly if treated with them in a proper manner.

I am a health professional but having never met the OP and without the benefit of a lot of evaluative test resuklts (most of which it sounds like have yet to be done) I cannot remotely say whether or not he would benefit from any medication, let alone which type. What I can say is that his symptoms are serious and require detailed evaluation in a clinical setting in order to rule out possible physical causes and determine the exact nature of the problem so that appropriate therapy can be instituted. The sooner the better.

Spot on Sheryl I could not have said it better myself.

[meom]

To say that antidepressants and antipsychotics are always useless and/or harmful is just as silly as to say that they are always the answer.

These are potent drugs which, like all pharmeceuticals, have a range of efficacy and side effects. Properly used (right choice of drug and dosage specific to the nature of the problem) they can be highly effective for those people whose condition warrents it. Used improperly or unnecssarily, they will cause problems.

Same could be said of any class of drugs.

Owing to the subjective nature of the symptoms involved, there probably are more mistakes made with pyschotropic drugs than other presecriptions, and indeed some doctors do over prescribe them and/or prescribe the wrong type of drug, making matters worse. This in no way alters the fact that there are people who need these drugs and will benefit greatly if treated with them in a proper manner.

You're probably right although in the case of psychotropic drugs it is often society that determines if symptoms need medication or not. That's why I doubt sometimes doctors motivation for prescribing certain medicines.

Anyway to the OP I can only say get the opinion of a doctor but don't take his opinion as a magic cure cause there ain't none.

Maybe you're head's a bit fvk up but as long as you're no danger to yourself or anybody else you might as well learn to live with it.

Edited October 23, 2006 by meom

[sobe]

baboon get to a real Dr. and have them do a complete work up/physical on you to rule out anything physical , blood work et, maybe even MDI .. I would definitely go to a psychologist first then a psychiatrist last the name I sent you was one of the top guys where you are .

[Ijustwannateach]

I have moved the general discussion of medicine and mental health to this thread. Please continue your debate about drugs, therapy, and other forms of treatment for mental health in *that* thread.

For comments DIRECTLY related to the OP's query about *his specific case,* please continue to post in *this* thread.

Thank you very much in advance.

"Steven"

[ray23]

You know I'm really glad that somone had the courage to post this. I'm a very and a retired cop. sometimes things get real ugly between my ears, for absolutely no reason. Depression creeps up on you nad you really have no idea whats going on. When the light finally goes on for me, I try to get busy at things I enjoy, but it takes a long time for that light to go on. It can be way down in depths before I key on what is really going on. Most of us have few people that we know well enough to talk about these kind of things with.

This is a wonderful place but it easy to get down here, especially if your retired. You go from a place in life where schedules are decided for you and communication with others is built in to not having much structure at all. Most of our mates don't have a clue so it is not something you can discuss with them. Developing trusting friendships is very difficult without the common shared factors of work

We have moved into a culture with a very different to the norm we are used and you have many things to learn, from buying toothe paste up. all the elements to key depression are certianly here. I guarantee it is not something to play with. You need help get it.

I'm lucky in that did get it years ago an learned to recognize it and find ways to deal with it. One of the ways, I seldom drink at all. I just don't need a depressant, if I'm already derpressed.

I try to stay in touch with friends from my pat via the internet. I did try to be very activein a locl forum, but in all hosesty the flaming became more then I cared to deal with. All it did was make me angry and I don't like the feeling.

I make an effort to try for enjoyable surrondings, people I can joke with and laugh with. Just makes my life better.

But the truth is that soemtimes you need more then that. If o seek out the hekp, no matter what you do it is up to you to make the move. By the time it comes to you it could very well be to late.

I wish the op all the luck in the world, but know your not alone and there are answers.

[benw]

Some Credentialed Foreign Mental Health Professionals in Bangkok

There are [limited] resources available here for people in distress and suffering from difficulties that come up in life. As a clinician, I'm aware of a number of qualified professionals people can turn to.

This is not meant to be a definitive 'List.' Nor is it meant to promote individual clinicians. It is intended to help increase people's awareness about well trained professionals available here in Bangkok (for people like op, who may benefit from being able to consult with a professional therapist). I believe that people are able to find help and help themselves in an amazing variety of ways- this list is meant to represent a sampling of one method to obtain help: therapy/counseling.

Many foreigners live outside Bangkok and may find this list not very helpful. Some of the organizations on this list will offer phone consultation. Other people choose to travel to Bangkok to receive treatment weekly, biweekly, or monthly. There are also useful self help resources on the internet (along with much that is not helpful)- for people interested in that, please get a copy of the Authoritative Guide to Self-Help Resources in Mental Health, edited by John Norcross (among others). It's an outstanding, peer- and consumer-reviewed guide to self help resources (book, video, internet) in a really broad range of areas.

How did I assemble this list? These are people who I am personally familair with who are able to provide mental health services (counseling/therapy, assessments) at a European/North American/Commonwealth standard of care. There are other credentialed mental health professionals I do not personally know (I don't recommend people I have never met). There are a very large number of uncredentialed people claiming to have credentials. Never be afraid to ask a provider about their training, experience, credentials, etc.

And adults are free, thank goodness, to spend their money on whatever treatment they prefer; I'm providing this incomplete and subjective list in order to help people who are interested in a professional consultation. I invite you to share any feedback about your experiences with these providers directly with me.

For more information, please contact each organization directly

NCS New Community Services

61/1 Soi Intamara 3

Sutisan Road

Phaya Thai (Sapan Kwai Area)

Tel.: 0-2279 8503

Fax: 0-2279 8502

[email protected]

Languages Spoken: Dutch, Thai, German & English (They may have added some other languages, including Japanese, but I'm not sure)

Opinion: The only clinic in Thailand I know if where well trained Thai counselors work side by side with well trained and credentialed foreign meantal health professionals. This is place to refer your Thai friends to for western style counseling.

Bangkok Psych Associates

Library Plaza 1000/200

Sukhumvit 55, Thonglor

Bangkok 10110

Languages Spoken: English

(02-712-7255)

Opinion: Credentialed professionals working with kids, teens and families

[email protected]

Psychological Services International

9/2 Sukhumvit Soi 43 (near Phrom Pong/Emporium)

Bangkok 10110,

Tel: 02-2591467

Fax: 02-2620505

www.psiadmin.com

Languages Spoken: English and French

Opinion: 3 licensed clinical psychologists (2 American, 1 Belgian); 1 licensed educational psychologist (Australian); 1 clinical social worker (American); 2 professional counselors. Working with teens, adults and couples. Educational assessment available

[full disclosure: I work at PSI]

Saisilp: The Centre for Creative Growth andProfessional Training

BB Building, 54 Soi 21 Sukhumvit

Tel: 02-2587562 press 0-Office

press 1-Khun Piyachat

Languages Spoken: Thai and English

Opinion: Piyachat R. Finney, ATR, CP. is one a new generation of Thai clinicians. Trained and credentialed in the US, she provides her expertise here.

Village Education Centre and Reed Institute have credentialed professionals providing educational assessment and interventions for children and teens who have learning and behavioral problems. Also- Reed Institute has at least one American licensed clinical psychologist and therefore able to provide therapy/counseling. She also specializes in eating disorders.

Bangkok also has two credentialed hypnotherapists I have met: John Kurkowski (many of you have seen his posts) and Karen Braddock. Bumrungrad is the only Thai hospital with a credentialed foreign counselor. Many private hospitals are now scrambling to hire Thai counselors, whose standard of training is not the same as other countries where counseling is an long-established profession.

I hope that people find this useful. In general, I prefer to read rather than post but in this situation, this information may be useful so I want to provide it. I just found about this thread (someone mentioned it to me). And thanks to the person who called my website amateurish. That was spot on and has motivated me to get back to working on it!

[Sheryl]

Benw, many thanks for thias post, it has long been needed. To the moderators: can be extract the list and post it? Questions about where to go for mental health needs arise regularly.

One other question to Benqw -- aere you able to comment at all on inmpatient pysch facilities in Thailand for persons either suicidal or psychotic and in need of hospitalization? From what I hear Bangkok General and Samitivej seem the best bets but I'd be interested in any observations you may have...

[Ijustwannateach]

Good idea, Sheryl. If anyone knows of any other resources, I'd be happy to add them in the pinned thread.

[benw]

One other question to Benqw -- aere you able to comment at all on inmpatient pysch facilities in Thailand for persons either suicidal or psychotic and in need of hospitalization? From what I hear Bangkok General and Samitivej seem the best bets but I'd be interested in any observations you may have...

It's difficult to make a generalization about this. This is a sensitive and difficult area where each case requires separate examination and judgment, based on individual circumstances. While I'm somewhat familiar with inpatient psychiatric facilities available for Thais, my experience with inpatient psych facilities that would be acceptable for foreigners is quite limited (I provide some training for Bangkok's largest inpatient psych facility, the Somdej Chaophraya Psychiatric Institute which provides good local care for the seriously mentally ill).

I think that some of the private hospitals can provide psychiatric care for people ready to be voluntarily hospitalized. That would be situations where someone has enough insight to realize that they need help that warrants hospitalization (for example, severe depression with suicidal tendencies, bipolar mania, detox from substance abuse). I don't have enough information or experience to point out a specific facility for their inpatient psychiatric care. There was apparently going to be a new, private psychiatric hospital for wealthy Thais and foreigners called Manoram Hospital, but I haven't hear much about it recently. While this could be a welcome addition to mental health resources in Bangkok, I currently have no information about their policies, procedures, etc.

It's not clear to me, however, that there are facilities for involuntary psychiatric hospitalization of foreigners (for acutely suicidal or psychotic behavior). I mean, what we sometimes call a "locked unit," where a psychiatrist/psychologist has the power to detain a person, against their will if necessary, because they may harm themselves (or others). Whatever you think of that, there are [highly infrequent] cases where it is called for (and even in the US, many people discharge themselves from such units AMA- against medical advice). My understanding, which may be mistaken, is that no private psychiatric unit exists in Thailand where a foreigner can be detained against their will (the public institutions like SCP have rarely admitted foreign patients but they have to be floridly psychotic).

Thus, presented with a situation where the client represents a threat to themselves (I have yet to see a therapy client here where the person represents threat to others), I have sometimes recommended medical evacuation from Thailand (bearing in mind that this is a sensitive and difficult area where each case requires separate examination and judgment, based on individual circumstances). And of course, people are free to reject my opinion, as they should be.

If anyone has a friend who they feel is imminently suicidal, my recommendation is that same as what you have heard before: take action and don't wait. Frankly what's most common here is serious substance abuse, usually alcohol abuse. And alcohol use is the most serious risk factor for suicide (since alcohol turns all the red lights green). Feel free to contact any of the professionals on the list above for a consultation.

[OlRedEyes]

I am very wary of posting in this thread as I almost certainly will step on some toes, but feel the need to say something simply because of the close association I have had with so many cases of depression, some suicidal and some not.

I am not qualified in psychology, but have had a lifetime of experience in it. It is probably my strongest point.

I personally have yet to see or hear of a successful psychiatric intervention. Successful to me means long-term healing, or improvement to the point where the person can lead a fairly 'normal' life. The best I have seen is temporary alleviation of the symptoms, either by medication, therapy or hypnosis. All too often this is followed later by a deepening of the original problem as the sense that nobody seems able to help you sets in.

Mind altering drugs are dangerous, and should only be used as a temporary platform allowing you the space to find the real problem and address it. Unfortunately, professionals seldom have the time to really understand you, so inevitably you are categorised and filed under a wide 'heading'. This will seldom result in a satisfactory outcome.

Nobody knows you like yourself. You have to find the problem, even if led by a psychologist or hypnotherapist. And YOU have to come to terms with the problem once you found it. (Excluding of course a 'hard' chemical or other brain problem. Most cases are 'software' problems, experiences, fears etc,)

Point is, there are some posters on this thread giving some good advice, sleepyjohn for one. Depression is a tough nut to crack, and just putting your faith in professionals are unlikely to cut it IMHO. Sure use them, but the bulk of the responsibility in finding the root cause will almost certainly be on your own shoulders. You have to know yourself, many people never really do.

Edited November 2, 2006 by OlRedEyes

[sriracha john]

That's the reason for the adage,

"Depression is the worst of all possible human conditions."

and is why it requires a multi-faceted treatment program for any hope of even minimal improvement.

Going it alone is no solution. Putting all on the doctor is no solution, either.

[John K]

As with any problem the cause must be eliminated or resolved for lasting results. That is not to say another cause could pop up later. Many people have situational depression. One the situation passes they recover many times on their own. A good example is seasonal depression that is directly related to lack of daylight.

But what was mentioned is very true, every person need to be evaluated. Although the symptoms may be the same the cause can be anything. The is no one size fits all fix.

[ColPyat]

My understanding, which may be mistaken, is that no private psychiatric unit exists in Thailand where a foreigner can be detained against their will (the public institutions like SCP have rarely admitted foreign patients but they have to be floridly psychotic).

Somdej Chao Paya is though maybe the best bet to detain psychotic foreigners. Many years ago i brought one case there from a police station, and he was straight away admitted, without any questions asked.

They have also within a day stabilised the guy, and within a few days he could be transported back to his home country.

[sobe]

I am very wary of posting in this thread as I almost certainly will step on some toes, but feel the need to say something simply because of the close association I have had with so many cases of depression, some suicidal and some not.

I am not qualified in psychology, but have had a lifetime of experience in it. It is probably my strongest point.

I personally have yet to see or hear of a successful psychiatric intervention. Successful to me means long-term healing, or improvement to the point where the person can lead a fairly 'normal' life. The best I have seen is temporary alleviation of the symptoms, either by medication, therapy or hypnosis. All too often this is followed later by a deepening of the original problem as the sense that nobody seems able to help you sets in.

Mind altering drugs are dangerous, and should only be used as a temporary platform allowing you the space to find the real problem and address it. Unfortunately, professionals seldom have the time to really understand you, so inevitably you are categorised and filed under a wide 'heading'. This will seldom result in a satisfactory outcome.

Nobody knows you like yourself. You have to find the problem, even if led by a psychologist or hypnotherapist. And YOU have to come to terms with the problem once you found it. (Excluding of course a 'hard' chemical or other brain problem. Most cases are 'software' problems, experiences, fears etc,)

Point is, there are some posters on this thread giving some good advice, sleepyjohn for one. Depression is a tough nut to crack, and just putting your faith in professionals are unlikely to cut it IMHO. Sure use them, but the bulk of the responsibility in finding the root cause will almost certainly be on your own shoulders. You have to know yourself, many people never really do.

OlRedEyes nice post

[markwhite]

Possibly there are competent farang psychiatrists here.It would be useful to know.

I've been involved in the area of mental health for about 16 years, but would not describe myself as a psychiatrist.

AIUI, a psychiatrist attributes mental disease to physical causes. Such as abnormalities in hormones. And treats them with medications based on restoring the balance. Psychiatrists can succesfully treat severe personality disorders, but in the case of minor mental health problems, drugs may not be the only answer.

I come from a humanistic pyschotherapy background which considers the individual's experience in their lives and sees mental health issues as an imbalance between the way they live their lives now, and how they could live their lives in a way that is more balanced. The approach gives no answers and no 'you should' direction. It helps the individual to realise their own resources and that they can solve their problems themselves, with time and patience. They learn to cope, so that when future problems arise, they no longer get fixed into inaction, the frustration of which is often the cause of stress, depression and anxiety.