Wellbeing and Mental Health

What Thailand can teach us about mental health

A man sits on a boulder at the seaside in the Thai resort city of Hua Hin, about 200 km (125 miles) south of Bangkok February 26, 2009. Hua Hin is the host for the 14th ASEAN summit, scheduled to be held in Thailand's Prachuap Khiri Khan province from February 27 to March 1, 2009.     REUTERS/Adrees Latif  (THAILAND) - GM1E52R03AJ01

'For a long time, we have neglected what being an empathetic human means' Image: REUTERS/Adrees Latif

Amornthep Sachamuneewongse
Founder, Sati App
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  • If we do not increase our efforts to tackle mental health problems, the global economy could lose up to $16 trillion by 2030;
  • In Thailand, more than 3 million people live with poor mental health and face stigmatization;
  • The Sati app aims to address the issue while offering a more empathetic approach to mental health care.

By the time you’ve finished reading this article, at least four people will have taken their own lives. According to the WHO, there is one death by suicide every 40 seconds and each year more than 800,000 people end their own lives. One of the leading causes of suicide is mental health disorders. Globally, one in four live with some sort of mental health disorder – around 450 million people.

Have you read?

I have been living with major depressive disorder and schizophrenia for the past four years and have gone to extremes to get treatment. Since early 2015 I have experienced severe headaches, loneliness, lethargy, self-loathing, self-doubt and social isolation. My family had no idea what was happening. I had a brain MRI to determine if there was anything wrong and nothing was found. Towards the end of 2015, I started having both visual and auditory hallucinations. We pursued a spiritual route, but the continued unknown only made things worse.

In 2016, I finally saw a psychiatrist and was diagnosed with major depressive disorder and Schizophrenia. By April 2016, I was taking 16 pills a day, had had Electroconvulsive Therapy (ECT) 36 times, had suicidal thoughts and was severely self-harming. With medication and treatment, my weight increased from 95 to 150kg which meant I had to stop my ECT treatment as I would stop breathing under anaesthesia. I began treating myself with medication and other types of therapy including talking with close friends, cooking, art and music.

Being constantly in and out of the hospital took a toll on me. Being outside gave me a sense of freedom; while being inside gave me a sense of security. Outside of the hospital, mental health was widely stigmatized and not many people understood it.

Common responses to mental health disorders
Common responses to mental health disorders

In 2018, I decided to call the suicide hotline, but my call went unanswered. Out of the hospital, I was frustrated and kept asking why no one had picked up my call. I realized that the hotline I’d called works only between 12:00-22:00. I was later given another number of a government-run centre, but, after waiting on the call for five minutes, I gave up.

Turning traumatic experiences into solutions

My frustration and my years dealing with my own mental health motivated me to investigate the problem in Thailand. Through research, I started piecing together the lack of understanding, help and empathy towards mental health.

  • More than 3 million Thais live with poor mental health;
  • Every 9 mins 55 secs, one person attempts suicide;
  • Every two hours, one person is pronounced dead as a result of suicide;
  • More than 50,000 people attempted suicide in 2018;
  • There were 4,134 deaths registered as suicides in 2018;
  • Not all deaths were reported owing to stigmatization;
  • The government-run suicide hotline received 800,000 calls in 2018;
  • Less than 20% of the calls were answered by the hotline owing to a limited number of staff and lines.

Taking all this into account, I started my own project, Sati, an on-demand, listening service that connects users with a trained, empathetic listener via an app.

What users can expect from the Sati app
What users can expect from the Sati app

Real-time data collection will allow us to create prevention strategies for the future.

How the Sati app uses 'listeners'
How the Sati app uses 'listeners'

Users will reach listeners who use the same dialect based on their location and preferences.

Why invest in mental health?

If we do not increase our efforts to tackle mental health problems, the global economy could lose up to $16 trillion by 2030. In the US alone, the cost of one suicide is estimated at $1.32 million. Despite these figures, mental health has been neglected globally. The actions of one group alone will not change this. We need the private and public sectors and advocacy groups to tackle the issue plaguing societies across the globe.

Mental health is one of the most stigmatized issues in Eastern cultures. We need to provide far better education on the issue for the public, as well as for the media, in order to prevent copy-cat suicides or the Werther Effect. Apart from educating the public, governments need to dramatically increase their spending on mental health. According to the WHO, in 2017 the global median for mental health expenditure was only $2.5 per capita compared to $141 per capital for general domestic health. There is also a shortage of mental health workers – the global median is 9 workers per 100,000 people.


The private sector needs to invest in mental health. One study suggests more than half of millennials and 75% of Gen Z have left their job for mental health reasons. For the private sector, this is alarming as it shrinks their workforce. According to a Deloitte study, there is an ROI for businesses who invest in employees’ mental health, but companies may need to wait at least three years before seeing returns.

Mental health advocates play a major role in tackling, destigmatizing, empowering and creating an understanding of mental health. This is because many, if not all, of these advocates have lived experience with mental health disorders. There is no one cause, one solution or one way a person will experience these disorders; my experience with major depressive disorder may be similar but is not the same as the next person. This is why we need to empower those living to share their stories. The more we are able to share, the more understanding we will have of the issue and the more we can assure those currently living with mental health disorders that they are not alone.


For a long time, we have neglected what being an empathetic human means. We have always been taught how to present and look smart and intelligent, yet when it comes to listening from our heart, we don’t know what to do.

Let us work towards a world where we don’t just look at GDP to tell us how well our economy is doing, but rather at the well-being of people. Let us move towards a world where ROI doesn’t mean return on investment, but “return on individuals” instead.

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