Development of a surveillance and care system for serious mental illness with high risk to violence patients in communities with community network participation, Buriram province
Keywords:
community network participation, SMI-V, surveillance and care systemAbstract
Objective: To develop and evaluate a community-based surveillance and care system for patients with serious mental illness with high risk of violence (SMI-V) in communities.
Methods: A research and development study was conducted in Buriram province from October 2021 to September 2023. The study was divided into five phases: 1) investigation and analysis of the existing system and its challenges, 2) model development based on the Department of Mental Health guidelines and the community participation framework, 3) trial of the developed model in pilot areas, 4) model evaluation and improvement, and 5) model implementation and evaluation. The sample groups were selected through purposive sampling and consisted of healthcare providers, community network partners, and SMI-V patients with their caregivers. Data were collected using the in-depth interview and focus group discussion guidelines, the Overt Aggression Scale (OAS), psychiatric assessments, and referral forms. Data were analyzed using descriptive statistics for quantitative data and content analysis for qualitative data.
Results: The developed system, known as the Buriram SMI-V value chain, expanded its reach to all 23 districts in Buriram Province. Compared with before the implementation, the treatment and continuous care rates among SMI-V patients increased from 87.7% to 100% and from 68.8% to 99.2%, respectively. The incidence rate of SMI-V decreased to zero.
Conclusion: The developed system has the potential to strengthen community networks and reintegrate mental health patients into the community.
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