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The Development of Thai Mental Health Indicator (TMHI) : From past to present

The Development of Thai Mental Health Indicator (TMHI) : From past to present. Presented By: Apichai Mongkol (et al) Deputy Director-General Department of Mental Health,Thailand,.

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The Development of Thai Mental Health Indicator (TMHI) : From past to present

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  1. The Development of Thai Mental Health Indicator (TMHI) : From past to present Presented By: Apichai Mongkol (et al)Deputy Director-General Department of Mental Health,Thailand,

  2. The Researchers Mongkol, Apichai Deputy Director of Department of Mental Health, Ministry of Public Health, Thailand Tangseree, Tavee Director of Khon Kanen Rajanagarindra Psychiatric Hospital Udomratn, Pichet Department of Psychiatry,Faculty of Medicine, Prince of Songkla University and et al.

  3. Introduction • Thailand have developed the variety of instruments to measure mental health of Thai people such as - Thai Mental Health Indicator (Suwanee et. al, 1987). - The Development of Mental Health Indicator (Amphorn et al, 1997). - Quality of Life (Thai version) (Suwat et al, 1997). - Thai Mental Health Questionnaire (Sucheera et al, 1999).

  4. These instrument had some weak point such as * didn’t covered with in mental health definition. * Data collection from patient population/ hospital setting.

  5. Department of Mental Health Developed Thai Mental Health Indicator (TMHI) since 2000 to measure mental health or happiness of all Thai people (happiness and mental health are the same subject in Thai culture) by Cover with the mental health definition in the context of Thai culture. Data collection from general population.

  6. The aim of this paper is present the process of developing the Thai Mental Health Indicator from 2000 to nowadays Now this instrument has been used nationwide.

  7. Result of development of TMHI : From past to present TMHI-new version (2003) was developed under definition of mental heath : “a good mental health or well-being resulted from mastering the competency of daily problem-solving and the potential of self development toward a better quality of life, which covering psychological quality under changing social environment”

  8. Development in 3 Phases Phase 1 * Reviewed related documents and researches * finally it had 80 items included 4 domains (21 sub-domain) : 1. mental state 2. mental capacity 3. mental quality 4. supporting factors.

  9. Phase 2 TMHI (2003) was studies the first construct validity with 2,024 population from 15 provinces in 5 regions. reduced items by factor analysis with experts meeting. TMHI remained the same domains and sub-domains but reduced items from 80 to 73 items.

  10. All provinces in each region Provinces with rich economic status Provinces with middle economic status Provinces with poor economic status District government (Or-bor-tor) level 1-2 District government (Or-bor-tor) level 3 District government(Or-bor-tor) level 4-5 Figure 1 : the sampling method in study II Metropolitan orcity municipalgovernmentadministration 1 Village of district government (Or-bor-tor)level 1-2 City municipal governmentadministration 1 Village of district government (Or-bor-tor)level 3 City municipal governmentadministration 1 Village of district government (Or-bor-tor)level 4-5

  11. Phase 3 : TMHI (2003) was to study the second construct validity and norm of the instrument with 73 items from phase 2 data collected with the same determination of sample size, added 380 samples reduced items by factor analysis with experts meeting TMHI was divided into 2 forms : complete form included 54 items and short form 15 items.

  12. Sub-domain Domain Figure 2 : Domain and sub-domains of TMHI-54 1.1 General well-being positive affect (4 items)1.2 General well-being negative affect (6 items)1.3 Perceived ill-health and mental illness (3 items) Domain 1Mental State(13 items) TMHI54 2.1 Interpersonal relationships (3 items)2.2 Expectation achievement congruence (3 items)2.3 Confidence in coping (5 items)2.4 Inadequate mental mastery (4 items) Domain 2 Mental Capacity15 items)

  13. Subdomain Domain Figure 3 : Domain and sub-domains of TMHI-54 3.1 Kindness and altruism (6 items)3.2 Self esteem (2 items)3.3 Faith (3 items)3.4 Creative thinking and enthusiasm (3 items) Domain 3Mental Quality(14 items) TMHI54 Domain 4 SupportingFactors(12 items) 4.1 Social support (2 items)4.2 Family support (4 items)4.3 Physical safety and security (2 items)4.4 Health and social care (4 items)

  14. Construct validity study was used factor analysis. Cronbach’s Alpha coefficient to study the reliability. Kappa statistic to study the agreement between the complete (TMHI-54) and brief (TMHI-15).

  15. Table 1 : Descriptive statistic and reliability value of domain 1,2,3 and 4 of TMHI-54 (n-2,401). Alpha 0.83 0.81 0.86 0.83 Potential rang 0-39 0-45 0-42 0-36 Obtained rang 5-39 8-45 0-42 0-36 Factor Domain 1. Mental state 2. Mental capacity 3. Mental quality 4. Supporting factor Number of item 13 15 14 12 X 29.83 28.00 27.75 22.89 S.D. 4.70 4.97 5.12 4.59 4 Domains 15 Sub-domains

  16. Table 2 : The norm values of TMHI-54 and TMHI-15 (n-2,390). Statistic MeanStandard deviationMedian25th percentile75th percentileMaximumMinimumPotential rangObtained range Range TMHI-1531.024.75 31.0028344590-459-4536 TMHI-54 108.3014.46109.0099117161390-16239-161122

  17. Score and meaning of TMHI-54 118-162 (>75 th percentile) = better mental health 99-117 (>25 th- 75 th percentile) = average mental health 98 points or below (>25 th percentile) = lower mental health

  18. Score and meaning of TMHI-15 35-45 = better mental health 28-34 = average mental health 27 points or below = lower mental health

  19. Table 3: The value of agreement study between TMHI-54 and TMHI-15 PairsTMHI-54 and TMHI-15 Kappa statistic 0.63 95% CI0.60-0.66 Kappa statistic 0.61 – 0.80 = Substantial (Landis & Koch,1997)

  20. TMHI includes 2 forms : TMHI – 54 is a complete form will be use if the user requires to study complete mental health and cover with all sub-domains.

  21. TMHI – 15 is a brief form will be use if the user requires to study with rapid and convenient condition.

  22. TMHI has been developed to be a reliable instrument for assessing the mental health of the Thai population under the context of Thai society and culture.

  23. It has been used to investigate the country-wide happiness of Thai people in 2003, 2005 and 2007 (on process of clean data and analyzing). The results of the three time surveys could be compare to show the trend of happiness of Thai people. Year Better Average Lower 2003 20.2 % 58.6 % 21.1 % 2005 24.4 % 43.7% 31.9 %

  24. Thank you for your Attention

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