Why it should be ok not to be ok – also in Thailand

By the time you‘re finished reading this blog, at least one or two people have taken their own life. The WHO (World Health Organization) estimates that every four minutes, someone in this world commits suicide and mental health conditions rank among the top reasons.


October 10, 2022 marks the 30th anniversary of World Mental Health Day. This day was created by the World Federation of Mental Health and is celebrated by big companies, influential individuals and people with mental health issues. It gives people the chance to speak up about mental disorders and their impact on their lives, share their knowledge to raise awareness about mental wellness and celebrate neurodiversity. Since 1994, the day has been celebrated with an annually changing theme – this year it was ‘Make mental health and well-being for all a global priority ‘.

Mental disorders are characterized by a clinically significant disruption of a person’s ability to think, behave or regulate emotions. It is often indicated by experiencing impairment or distress in crucial areas of functioning.

There are different forms of mental health issues including: Bipolar disorders, Eating disorders, PTSD(Post-traumatic stress disorder), OCD (Obsessive-compulsive disorder), Schizophrenia, Neurodevelopmental disorders, Borderline personality disorders and Disruptive behaviour and dissocial disorders. However, the most common ones are anxiety and depressive disorders with 4% and 3.8% of the global population affected. According to the WHO a 25% rise in the global occurrence of anxiety and depression was seen in 2019 due to the COVID-19 pandemic.

The notion that mental health is important for one’s well- being is nothing new, but in recent years more big health organizations acknowledged mental health as a barrier for achieving the Social Development Goals (SDGs). A historic step was taken in 2005, when the UN made mental health a priority for the achievement and adopted the notion of taking care of one’s mental health into the third of the Social Development Goals. Mental health is now mentioned three times within this goal, most noticeably in the fourth target : ‘reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being’. The inclusion of mental health in this goal clearly shows health shouldn’t only refer to the physical but also to the psychological aspects of our being. Despite the important acceptance of this fact that might be a huge step towards the normalization of mental health issues, there is still a lot of culturally consolidated stigma – in the forms of criticism, assumptions, and victim-blaming. Victim-blaming in this case refers to people who claim the right to state the affected person would be the one to blame for their own mental health issues.  

The first step after realizing there might be something wrong with one’s own mental state is to speak up about it.  This can already be a scary process as they have to admit they cannot longer fight whatever is going on alone – and the prejudices only complicate this. Hence, they are afraid of judgement, denial and not to be taken seriously. However, trying to sort this out with yourself alone usually makes it worse and might result in feelings of loneliness or self-harm. 

So, let’s look at the areas of life that can be affected by our mental health.

 Emotional Well-being and Physical Health

A negative mindset can make you feel irritated, sad, overwhelmed, or disturbed. People often lose interest in certain things and feel unable to accomplish small tasks. When we are emotionally feeling good, it can result in increased productivity, better work performance and efficiency.

In recent years, much more importance has been given to the human mind-body connection. Physical health problems significantly increase our risk of developing mental health problems, and vice versa. One-third of people with chronic physical health problems also have a mental health problem. Mental illness can affect not only how we eat, sleep and move our bodies but also our immune system. Our body’s ability to cope with illness may be jeopardized because the body is trying to fight something else first.

Relationships, Community and Society

Mental illnesses influence how we interact with others  and can lead to dismissive, distraught, or passive aggressive behavior which can confuse or upset other people and lead to the weakening of the quality of a relationship. People who struggle with their mental health might feel the incapacity to participate in social activities and therefore abandon their friends and family.

As studies found out, children who grow up with parents or other adults who have mental health issues are more likely to experience abuse, feeling or being neglected and develop behavioural issues. Some might be likely to struggle with mental health themselves or with being socially accepted when they grow up.

Violence, Crime and Victimization

Poor mental health puts one at increased risk of committing violent crimes. Most of the time those go against one’s own family.  Furthermore, it can lead to self-victimization, self-harm and different forms of abuse. This is increased if the person takes drugs, consumes alcohol or medication.

Even though the globa suicide rate declined from 11 deaths per 100,000 population in 2009 to 9.2 deaths per 100,000 in 2019 it is globally one of the leading causes of death.

Quality of life

When mental health issues are not treated, people often feel a sense of hopelessness, sadness, worthlessness, guilt, fear, and a perceived loss of control. This immensely impacts the quality of life as with increased thoughts of worry it becomes harder to focus on the good things in life.

What about Thailand?

According to UNICEF the state of mental health in Thailand is catastrophic.

Mental health issues occur more often in Thailand’s younger generation, affecting approximately 1 in 7 teenagers (10 to 19 years old) and 1 in 14 children (aged 5 to 9). According to  Thailand’s UNICEF representative Kyungsun Kim, the actual number is thought to be even higher.

According to Thailand’s Deputy Health Minister Dr. Konsomboon, the most prevalent mental health issues are psychosis, anxiety disorders and depression with estimatedly  1.5 million Thai people dealing with the latter.

The causes of mental health issues and the main barriers to normalization of those can rarely be narrowed down to a single factor as they are deeply rooted in Thailand’s society, religion, economy and health care system. Researchers found that people who live in a lower socioeconomic position are of higher risk to develop mental health disorders. The gap between rich and poor creates the lack of access to mental health facilities as well as increased societal pressure. While Thailand has a mental health policy in place it does not contain a service strategy, planning, or patient protection in terms of human rights.

Thai Culture and sĭa nâa

However, mental illness in Thailand is not seen for what it is. It is commonly seen as a weak state of mind – due to the influences of family, media, and education.

A very Thai phenomenon is spirit possession. The person affected (possibly by mental issues) gets ostracized by Thai society as a result of being possessed by an evil spirit. It is viewed as unpleasant, with those individuals believed to have been cursed or to have caused it through poor karma.

Cultural factors such as teaching children to lower their voice in public and be obedient towards authority figures might result in lower reported cases of ADHD for example.

As Thai culture is one with high expectations engrained, young people often feel additional pressure when it comes to providing for one’s family, making them proud and succeed in education.

In Thai language sĭa nâa , meaning ‘broken face refers to the culturally ingrained aspect of  not to be embarrassed or look like a fool. However, the concept of not to  ‘lose your face’ is a major hurdle to accepting mental health issues.  

Especially women in Thailand are experiencing additional pressure as they are exposed to a plethora of new methods to seem more appealing via beauty products and beauty technology. Modern culture has established a high competitive standard for what is deemed beautiful. The downside is rather obvious: it can have extreme influences on one’s self esteem.

Looking at the bright side of life

Just to mention some examples, there is not only a rise of  Mental Health Activists in Thailand but also just recently UNICEF Thailand, together with JOOX Thailand and the Department of Mental Health, released ‘The Sound of Happiness’, a podcast with 12 episodes that aim to support children and youth in coping with their emotions and to look after their mental health.  

The most effective way to invest in mental health is through a multi-sectoral, all-encompassing approach. Community-based participation, primary care services, public health, social protection, employment and education are crucial components of a “whole-of-society strategy“. This cross-sectoral, political, and financial aid for mental health is necessary. If awareness is actively increased, we would better be able to establish support facilities and resources for those dealing with a form of  mental illnesses. It would have the potential to create a more knowledgeable, understanding, accepting and kind global society and hence, the increased chance of recovery and support in situations of mental unwellness. 

To find out how you can take care of your own mental health – read this blog How to check in on your mental health + 7 questions to ask yourself every day – WellTuned by BCBST (bcbstwelltuned.com)

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