The Development of Care Model for Substance Abuse Patients with Psychiatric Symptoms at Risk of Violence through Multi-Stakeholder Collaboration at Kosum Phisai Hospital, Maha Sarakham

Abstract

Purposes: The study aimed to assess the current situation, develop a care model, and evaluate the effectiveness of a model for substance abuse patients with psychiatric symptoms at risk of violence, through the collaboration of stakeholders at Kosum Phisai Hospital, Kosum Phisai District, Mahasarakham Province.                                                    

Study design: This was an action research study based on the concepts of Kemmis and McTaggart.

Materials and Methods: The participants consisted 1) Seven healthcare professionals at Kosum Phisai Hospital, 2) Sixteen stakeholders from the community network, and 3) Twenty substance abuse patients with psychiatric symptoms at risk of violence receiving treatment. The instruments were a group discussion guides, an Aggression Behavior Assessment Scale, a Quality of Life Assessment Scale, and a Care Guideline Manual for Substance Abuse Patients with Psychiatric Symptoms at risk of Violence. The content validity Index of the instruments was 0.96. Data analysis were conducted using content analysis, percentage differences, and paired t-test.                                      

Main findings:  The findings revealed an increase in both the number and severity of substance abuse cases with psychiatric symptoms at risk of violence. The existing treatment system was inadequate for addressing the severity of cases. The developed care model for substance abuse patients with psychiatric symptoms at risk of violence consisted of three key components: 1) Pre-Hos: rapid and accurate screening to ensure timely intervention, 2) In-Hos: comprehensive inpatient treatment services, and 3) Post-Hos: community-based follow-up care to prevent relapse. Post-intervention results showed a statistically significant improvement in the quality of life of the 20 substance abuse patients (p < .001), with 100% of participants remaining substance use relapse.                                                     

Conclusion and Recommendations: The developed care model, which involves multi-stakeholder collaboration, effectively improved the quality of life for substance abuse patients and prevented relapse. The model has shown promising outcomes, but further experimental research with a longer follow-up period is recommended to better assess its long-term effectiveness.