Document analysis and collateral description

In addition to data collected from human sources through interviewing and participant observation, this study also used data from documents and media produced by Centre 12 in responding to the mass violence situation. Documents and other written materials were collected from the Centre’s official website, four annual reports, and five training manuals. Those documents were used for answering RQ 1. The documents also allowed for cross-checking with the interview data to further explain mental health communication programmes launched in the 10 years of the on-going crisis. Five booklets using religious principles in mental health healing and rehabilitation were chosen for analysis as they were recommended by most of the Centre’s staff as outstanding media. The analysis of these booklets was then used to answer RQ 2 and RQ 3, which cover the planning and implementation of mental health communication programmes.

Yin (2009) emphasised four strengths of using document analysis as part of a case study: stability; unobtrusiveness; providing the exact name, reference, and detail of an event; and broad coverage. Documents are most important in case study research as they support or analyse the evidence from other sources. Consequently, I used documents from Centre 12’s website and annual reports to verify the correct spelling, title or names of any organisation recorded in the interviews, and read annual reports before interviews and observations. This was useful to see whether the evidence from the variety of sources was consistent or contradictory and allowed me to ask additional questions or observe more specific practice points.

94

Documents are “constructed in particular contexts, by particular people, with particular purposes, and with consequences—intended and unintended” (Mason, 2002, p. 110). I was guided by Mason in the analysis of the five booklets, exploring why and how these documents “were prepared, made, or displayed, by whom, for whom, under what conditions, according to what rules and conventions, and what they have been used for, whether they have been kept and so on” (Mason, 2002, p. 110).

The five booklets are religious-based media supporting the mental health communication programme, Healing according to Buddhist and Muslim Principles. Among these five booklets, two were produced for Muslims (How to respond when we are tested and Mental rehabilitation by Du-a [praying]) and three were produced for Buddhists: Self-awareness and mental treatment, Rehabilitating ourselves, and

Rehabilitating other people. Further details and pictures of these five booklets are presented in Appendix F.

There are, however, limitations in undertaking document analysis. According to Mason (2002), “documents may be more or less detailed and comprehensive, they may or may not be authentic and genuine (what they purport to be), reliable, accurate, and so on. They may or may not be readily identifiable and available” (p. 110). I was concerned about this limitation and was also apprehensive about over-relying on documents, most of which were official materials and annual reports. The documents were useful to confirm and provide more information in support of the interviews, and were carefully compared with interviews to help investigate how closely official reporting matched the views of those undertaking the activities

3.6

Document analysis and collateral description

Review of the draft report by those who have participated in the study is an essential way to improve the quality of case studies and to ensure their validity: “From a methodology standpoint, the corrections made through this process will enhance the accuracy of the case study, hence increasing the construct validity of the study” (Yin,

2009, p.183). This process can be used to confirm important facts, identify any disagreements, and as an opportunity to search for further evidence. Furthermore, the review could also provide more information that the participants might not have recalled during the initial data collection period.

95

In this study, participants reviewed the draft findings when I returned to Thailand. On April 27, 2016, I went to Songkhla Rajanagarindra Psychiatric Hospital where Centre 12 conducted its monthly meeting. (See Appendix L for the summary sheet I provided for the attendees). The Director and eight of the original participants, along with ten other people, mainly public health officers, and administrative and financial staff of the Centre, attended my briefing. The session lasted from 9 am to 10 am.

The Director talked briefly about my study and her interest in the evaluation of the Centre’s manuals and books. I then introduced myself and explained how the study’s focus had changed from the original focus on media to the Centre’s overall practices and identified this study as a case study. I summarised the total number of participants and data collection methods, emphasising that this review meeting was important to enhance the accuracy of the findings. I talked through the findings slowly and the attendees gave feedback as I went along. There were two sections of my presentation: contextual findings and the Centre’s practices in mental health communication programmes. For the first section, I used a timeline of mental health service delivery between 2004 and 2014, which I had mapped out. After looking at the timeline, the Director said there was an error about the years in which the Centre worked on behalf of the Rehabilitation Sub-Committee. Furthermore, the Director and staff also said that in the last phase of the Centre’s practice, they were not only working with the four groups aligned to the developmental stages of life, but also worked specifically with complicated cases, such as people who were suspected to be the terrorists and those with disabilities.

In the second section about the Centre’s practices and mental health communication programmes, I presented the participants’ perceptions of their work and the mental health communication programme cycle (planning, implementation, and evaluation). The Director and staff discussed the radio programming they had commissioned and confirmed they did not participate in selecting actual content of the programme. The participants also agreed with my findings that the communication programme evaluation process was challenging for them and they wanted to know more about my recommendation for programme evaluation methods. The meeting ended with discussion of effective practices as perceived by the participants. The participants agreed with the findings in this section, especially about the role of the Director as one of the success factors. At the end of the meeting, the Director said this case study was

96

different from the other studies that had mostly focused on communication in the post- conflict stage.

3.7

Conclusion

This study uses the qualitative case study approach, which provides a wealth of detailed material so as to encourage understanding of human experience and social context. This chapter covers planning and research in practice. Ethical considerations applied during fieldwork were unpacked. During 2 months of data collection, 12 participants from the 12th Mental Health Centre and five partner group representatives were involved in three methods of data collection. Interview and observation data collected from these participants and from documents provided by Centre 12 form the basis of my analysis of the mental health communication programmes. The following chapter presents the findings on the 12th Mental Health Centre’s practices of mental health service delivery and mental health communication programmes in response to the mass violence crisis in southern Thailand from 2004 to 2014.

97

CHAPTER FOUR: POLICY IMPACT ON

MENTAL HEALTH COMMUNICATION PROGRAMMES

4.1 Introduction

This chapter aims to answer the first research question (RQ 1): “In what way did Thai government policies impact on the establishment, funding, and delivery of mental health communication programmes during the mass violence situation in southern Thailand?” The chapter initially provides a framework of mental health service delivery in two circumstances: the normal Thai situation, and the mass violence situation. The chapter describes the changing structures and functions of government agencies set up in response to mental health issues. The focus then turns to identify the 12th Mental Health Centre’s (the site of this study) development and roles as the centre of the mental health communication programme delivery. The section concludes with a summative timeline of mental health delivery across the 10 years studied.

The chapter presents material from interviews with the Director of the 12th Mental Health Centre, 11 of the Centre’s staff who participated in mental health communication programmes between 2004 and 2014. Additional data come from Centre 12’s 2012 annual report, along with documentation from websites of the 12th Mental Health Centre, National Statistical Office of Thailand, Pattani Provincial Health Office, Songkhlarajanagarindra Psychiatric Hospital, Southern Border Provinces Administration Centre, and Suansaranrom Psychiatric Hospital. Further confirmationary material was obtained from a journal article by the Centre 12’s Director on mental health therapy for people affected by the unrest in the study area (Tohmeena, 2013).

The key informants in this study were 12 Mental Health Centre staff members, including the Director. As explained in 3.5.1.1, although all staff members gave permission for their names to appear in the report, this study omits individual names, except for the Centre 12’s Director and an academic partner representative. Participants are referred to by numbers which reflect the interview order.

The demographics and work experiences of the informants are summarised in Table 4.1. This information is important because participants’ understanding of the area’s cultural and religious context will influence their perceptions of working in the area and how

98

they communicate about mental health issues. Where appropriate, the participants’ demographics and work experiences are also provided to contextualise interview comments.

99 T ab le 4.1 The C entre 12 D irector an d staf f m ember s ’ d emograph ics and wor k ex p erie n ce s

100

Haft of the staff members are trained psychologists – four are counselling psychologists and two clinical psychologists. Four other staff members, including the Director, graduated in public health and nursing, or policy and social planning. The last two staff members graduated in social work. The Centre staff’s hometowns are evenly spread: six were born in the three southern border provinces and the other six came from outside the area; however, in the southern provinces all except one staff member came from the eastern province of Thailand. Five staff members whose hometowns are out of the violence area have chosen to work at Centre 12 because it was near their hometowns and two of them have only ever lived or studied in this area. Eight of the participants, including the Director, are Muslims and four are Buddhists.

There is a range of experience present in the staff members. At the time of the study, six have worked with Centre 12 for between 1 and 3 years (during the new system following the restructuring of the Department of Mental Health in 2011); the Director and three staff for 8–9 years, and two staff have worked more than 10 years. These different levels of work experience are likely to influence informants’ reflections about the Centre’s practices, and their perceptions of designing and delivering mental health communication programmes.

4.2 Policies underpinning the mental health communication