Abstract
Objective: This study aimed to synthesize an integrated mental health service system for
depression prevention among higher education students in four provinces of Thailand: Khon Kaen,
Nakhon Phanom, Nakhon Ratchasima, and Ubon Ratchathani, utilizing the WHO's 6 Building Blocks
framework.
Methods: A mixed-methods research approach was employed. Data were collected from January
to October 2025. Participants included 62 key informants (executives and practitioners at regional,
provincial, and institutional levels) and 1,680 students from seven educational institutions.
Instruments consisted of a service system questionnaire, in-depth interviews, focus groups,
knowledge-sharing workshops, and the 9-item depression scale (e.g., PHQ-9). Quantitative data
were analyzed using percentages and means One-way ANOVA, Chi-square Test, Pearson’s
Correlation, Binary Logistic Regression Analysis of predictors of depression, and Qualitative Data
Analysis using Content Analysis., while qualitative data utilized content analysis.
Results: Findings showed a continuous increase in the prevalence of depression among youth in
the four health regions. Key contributing factors included family issues, academic pressure, social
difficulties, and challenges in adjusting to the online social era. The sample exhibited a prevalence
of mild/chronic depression at 19.25% and severe depression at 2.88%. The 6 Building Blocks
evaluation highlighted Leadership and Governance as a strength (clear policy, committed
leadership, and collaborative action). Areas requiring improvement were the Health
Workforce/Human Resources (insufficient psychologists and psychiatric nurses, especially in
educational institutions) and the Health Information System (lack of network connectivity among
partners and data redundancy).
Conclusion and Recommendations: The study proposes four national-level policy
recommendations: 1) Establishing a cross-ministerial Memorandum of Understanding (MOU)
among the Ministry of Public Health (MOPH), Ministry of Higher Education, Science, Research and
Innovation (MHESI), and Ministry of Education (MOE). 2) Defining a specialized personnel staffing
framework to mandate the presence of psychologists and psychiatric nurses in higher education
institutions. 3) Developing a centralized mental health information system to reduce redundant
tasks. 4) Creating incentive packages for personnel. Local-level recommendations include: 1)
Establishing Student Mental Health Centers with clear, continuous linkage mechanisms. 2)
Developing a healthy well-being environment on university campuses. 3) Implementing initial
psychological screening upon entry, quarterly follow-up monitoring, developing a mental health
emergency response plan, and conducting annual joint drills. The results underscore the urgent
necessity to truly develop an integrated mental health service system in higher education
institutions.
