Enhancing Recovery-Oriented Systems with Psychosocial Support for People with Mental Health Challenges in Thailand

Abstract

Recovery-oriented services (ROS) shift mental health systems from a focus on treatment and clinical recovery to holistic, person-centered approaches that value lived experience. Patient-reported outcomes (PROs) on health-related quality of life (QOL) and mental health recovery (MHR) provide critical insights for developing more responsive services. In Thailand, despite policy commitments, gaps remain in the implementation of recovery-oriented mental healthcare systems. This cross-sectional study aims to examine QOL and MHR outcomes from the service user’s perspective using the WHOQOL-BREF-THAI and MH-THAI (a patient-reported outcome measure as an adjunct recovery module) to inform the applicability of the measures and unmet needs to achieve recovery progress and well-being. Participants were 236 service users with schizophrenia, mood disorders, and other conditions (e.g., alcohol and substance use, anxiety, and personality disorders). Despite the demonstration of converged QOL and MHR scores to reflecting overall outcomes, these outcomes were better in the mood disorders group than in other mental health conditions and the schizophrenia groups, respectively. The problematic domain of QOL was social relationships, consistent with poor people skills and connections, and a belief in personal recovery, as reflected in the MHR outcomes, indicating unmet non-medical psychosocial support services. The PRO measures offer a practical way to explore unmet subjective needs, even in the context of a medical hierarchy and the persistence of self-stigma among service users in mental healthcare systems. The integration of peer support services, conducted by community-based organizations, with primary mental healthcare systems was recommended to promote recovery-oriented practices and a user-centered framework.