泰國一百三十年的精神醫療照護：過去、現在與未來

One Hundred Thirty Years of Psychiatric Care in Thailand: Past, Present, and Future

在本篇綜說中，作者想讓讀者熟悉近一百三十年來泰國精神醫療照護的演進，及其所伴 隨的國家經濟計劃發展與社會脈絡變遷。作者簡介當前泰國精神醫療照護架構的四個組成 層級（基層照護單位、社區醫院、綜合醫院、及大學精神科和精神專科醫院）並建議未來方 向。基於數位時代來臨與「中等收入困局 （middle-income trap）」，「泰國 4.0」經濟政策於 2016 年開始發展；作者於文中討論此模式在將來可能如何影響精神醫療照護。作者還分享 了其觀察台灣某醫學中心的經驗，並簡短的比較了台灣、泰國兩國的精神醫療照護體系。在 漫長的泰國精神醫療照護歷史中，作者強調了本地確實且在地的資源，將西方知識整合至泰 國文化的現代化進程，及政府的國家級計畫。除了從自身泰國歷史學習精神醫療照護，作者 認為其他國家的經驗，也有助於精神照護工作力及整個體系的永續發展。

In this overview, the authors intend to familiarize the readers with the evolution of psychiatric care in Thailand through a 130-year history, which is accompanied by the development of National Economic plan and the change of social context. The authors also provide a current psychiatric care framework in Thailand, consisting of primary care units, community hospital, general hospital, as well as psychiatric hospital and psychiatric department of the university four levels of care in understanding the current situation and suggesting for future directions. As a result of the digital era and “middle-income trap” situation, “Thailand 4.0” economic policy has been developed since 2016. The authors discuss how this model could impact psychiatric care in the future. In addition, the authors share the experience of observing a tertiary care hospital in Taiwan, and also briefl y compare Taiwanese mental health system to Thai system. From a long history of psychiatric care in Thailand, the authors have also highlighted positive native resources and modernization of psychiatric care by the integrating Western knowledge into Thai culture, and the national plan from government. Apart from learning psychiatric care from our own Thai history, we felt that experience from other country is a tool for sustainable development of mental workforce and also the entire system.