> [!info] **Why am I curious?** > **Why am I curious?** I have a personal interest in this subject. As a regular traveler to Thailand and having Thai friends, I often wonder about the mental health landscape there. Do they have similar mental health services as in Singapore? Considering their cultural differences, do mental health issues manifest in a similar or different way? What are the perpetuating and protective factors? For instance, is Buddhism, the predominant religion in Thailand, a protective factor? What about stigma associated with mental illness? How do people explain mental illness and their experiences? I understand that it’s not about imposing a “Western” or “developed country” template on Thailand. Instead, it needs to be localized and contextualized to fit the unique local settings. ## Mental health - 510 Senior high school students in Samut Songkhram have low mental well-being despite moderate mental health literacy. (https://www.researchgate.net/publication/396145299_Mental_health_literacy_and_mental_well-being_among_senior_high_school_students_in_Samut_Songkhram_Province_Thailand) - How come? - Academic compeition and exam pressure - societal and economic pressures -- inadequate infrastructure, quality of life, access to education, economic hardship, chronic stress - Rapid social and technological shift.. exposure to more competition from peers from outside. - Developmental Vulnerabilities during this period of late adolescence Actually Singapore kids not doing that much better... "[Of those aged 15 – 35 years, 14.9%, or about 1 in 7 youths, reported having severe or extremely severe symptoms of depression in the past week before the survey was conducted. Such symptoms include feeling sad, empty and a lack of interest and pleasure in activities, most of the time](https://www.imh.com.sg/Newsroom/News-Releases/Documents/NYMHS_Press%20Release_FINAL19Sep2024.pdf)." (Universal: Competition, developmental vulnerabilities, family/social systems.. ) ## Early Intervention Services - [[Lay health worker-delivered case management for earlyepisodes of psychosis in Bangkok, Thailand (Lay-CARE)]] Duration of Untreated Illness (DUI) - "Average 10 years" ! That's long.. how come? - https://www.researchgate.net/publication/352359112_Duration_of_untreated_period_of_psychiatric_conditions_in_Thailand Association between trauma exposure to psychotic experiences. This is pretty consistent with other studies - https://www.researchgate.net/publication/352213149_Traumatic_events_and_psychotic_experiences_a_nationally_representative_study_in_Thailand [Poverty, Psychological Distress, and Suicidality Among Gay Men and Transgender Women Sex Workers During the Covid‑19 Pandemic in Phuket, Thailand](https://link.springer.com/article/10.1007/s13178-023-00793-4) - Interesting for me, because i always thought that Thailand is very progressive regarding LGBT, but the author explained that "*However, the status quo of the LGBT community in Thailand is complicated and discrimination is commonplace in many contexts. In reality, while Thailand strives to promote its LGBT-friendly image, the LGBT community is still facing stigmatization and pressure to adhere to mainstream social norms (World Bank Group, 2018). Moreover, LGBT people in the labor market are still being discriminated against for a variety of reasons, such as gender identity, sexual orientation, HIV status, and being sex workers (Suriyasarn, 2016)*" - - Big picture: Covid tourism collapse → mass income loss among GM/TGW sex workers → high poverty, extreme distress, elevated suicidality, with distress partially mediating poverty → suicidality. - TGW worse off than gay men on depression/anxiety, reflecting intersection of transphobia, criminalized sex work, and pandemic‑driven economic collapse