The alternative is a crowded state psychiatric institute, competing for medical attention with other serious and chronic patients.

Realising that the choices for psychiatric patients are very narrow, a Thai psychiatrist spent over 20 years dreaming about a hospital that could offer better services with full facilities and appropriate environments for people with mental disorders.

"After working in the USA, I returned to Thailand and found that being a psychiatrist here was very troublesome," said Dr Chantima Ongkosit Krairiksh.

According to the Department of Mental Health, at least 10 per cent of the Thai population - about six million people - suffer from mental problems, while only 1.6 million seek medical services.

It is a huge number compared with the number of available psychiatrists, of whom there are only about 400, stationed mainly in 17 state mental hospitals.

Chantima said the number of patients exceeded the capacity of the state hospitals by at least 139 per cent.

"It's hard to treat patients without assistants and full facilities. However, patients and psychiatrists have no choice," said Chantima.

 "Over 94 per cent of Thai psychiatrists agree with that," she said, citing a survey she conducted four years ago.

Chantima was an assistant professor of psychiatry at the University of Illinois in Chicago, and was a lecturer at the department of psychiatry at Mahidol University's Ramathibodi Hospital. She also worked as a psychiatrist at a private hospital.

Through her experience, even in some private hospitals that had psychiatric departments, she realised that patients had to wait for months for a diagnosis.

The results of her survey revived her dream of establishing a new style of mental hospital - an idea which had failed twice before. The reasons, she says, were because of people's negative attitude towards, and misunderstanding of, psychiatric hospitals and patients.

"But today people have more understanding about mental illnesses," she said.

With about 80 psychiatrists entering into a partnership, Chantima set up the private Manarom Hospital last October.

"Mental illness ranks as the second most serious illness threatening the lives of people in developed countries and the fourth worldwide. In 2020, depressive disorders will be the second most serious illness threatening the entire world population," she said.

 "We want people to feel that seeking advice from a psychiatrist is an ordinary matter. There is nothing to be ashamed of and it doesn't mean you are insane."

Chantima believes that crimes committed by the mentally ill could be prevented from occurring if those people received appropriate treatment in time.

"What we do is not only to treat, but to prevent, and educate people about the illness," she said.

Apichai Mongkol, deputy chief of the Mental Health Department, said that apart from the estimated six million people suffering some form of psychosis, there were another six million people who suffer less serious mental illness. However, figures show that only one in four mentally ill people ever receives proper medical treatment.

"With the limited number of psychiatrists and facilities, we have to focus on serious patients first," he said. "This truly reflects the poor access to treatment for Thais suffering mental illnesses."

Apichai said private psychiatric hospitals could help relieve the pressure on crowded state institutes, each of which has to cope with an average of 1,000 patients.

Manarom Hospital targets the same group of patients as luxury private hospitals.

It has 56 beds for in-patients and provides individual treatment as well as social activities to help improve psychiatric conditions.

Dr Kraisit Narukhatphicha, the hospital's managing director, said the facility emphasised safety, privacy and a "healing environment".

He said that when mentally ill patients were admitted to general hospitals, they could cause trouble to other physically ill patients in the same wards.

General hospitals were thus not appropriate for psychiatric patients.

Manarom Hospital was intentionally designed with only two storeys in order to prevent suicide attempts. All the facilities in patient rooms are similarly designed for suicide prevention.

All patient information is kept secret and patients can even conceal their real names in the records if they so choose.

Since it opened, the hospital has treated about 30to 50 out-patients a day.

Chatrarat Kaewmorakot,

Chularat Saengpassa

The Nation