Abstract
This research, titled “The Situational Analysis and Systemic Limitations in the Care of
Homeless or Destitute Individuals with Psychiatric Disorders in Thailand,” aims to study the
current situation, analyze systemic limitations, and propose a comprehensive development
framework for the care of this vulnerable population. The study utilized both quantitative and
qualitative analyses, drawing data from 11 homeless shelters, two halfway houses, and 10
psychiatric hospitals under the Department of Mental Health.
The findings revealed that the homeless shelters accommodated a total of 4,047
individuals, of whom approximately 75% had mental health conditions and 42% had comorbid
physical health problems. The assessment based on the Individual Rehabilitation Program (IRP)
indicated that 32.99% of service users required intensive assistance (Level C), while only 5.78%
demonstrated high potential for reintegration into the community (Level A). Data from the
halfway houses reflected that the majority of residents still had significant limitations in life skills
and social functioning. In psychiatric hospitals, the number of patients classified as "without
family contact for over 30 days" increased from 526 in 2020 to 1,059 in 2024, more than
doubling within five years. The main contributing factors included the absence of caregivers
(40.0%), involvement in legal cases or substance abuse (17.7%), and discontinuation of
psychiatric treatment (13.3%).
This research proposes key policy recommendations, including promoting early diagnosis
and screening of psychiatric patients through the development of simple observation tools for
families and communities; enhancing the system for detailed screening and assessment of
patient capabilities; establishing aftercare support systems and community-based housing
integrated with respite care services to alleviate caregiver burdens; strengthening the capacity of
families and communities for long-term care; and developing a centralized database for
continuous patient tracking and care coordination.
