Voices of Network Partners on Challenges in Psychiatric Care and Community Support System Development
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Abstract
This descriptive qualitative study aimed to explore community network partners' reflections on challenges in caring for individuals with psychiatric disorders and to propose strategies for strengthening community-based support systems. Key informants were 24 community network partners involved in psychiatric care in Koh Kaew Subdistrict, Selaphum District, Roi Et Province, Thailand, purposively selected. Data were collected through focus group discussions using semi-structured in-depth interview guidelines. The interview guide was validated for content validity by three experts, with an Index of Item–Objective Congruence (IOC) ranging from 0.67 to 1.00. Data were analyzed using thematic analysis.
The findings identified two major themes. First, systemic limitations encompassed social stigma toward individuals with psychiatric disorders, ambiguous roles and coordination among network partners, the absence of referral and post-discharge follow-up mechanisms, and insufficient knowledge and confidence among community leaders and village health volunteers. Second, strategies for developing a support system included establishing local mental health expert teams, continuously strengthening the capacity of network partners, developing a clear continuity-of-care system with defined responsibilities following discharge, securing financial support from local administrative organizations, and leveraging social, cultural, and religious capital to enhance community acceptance of individuals with psychiatric disorders.
The findings suggest that subdistrict health-promoting hospitals should collaborate with village health volunteers and local administrative organizations to develop a subdistrict-level continuity-of-care system for psychiatric patients. The roles and responsibilities of each agency should be clearly defined, and standardized guidelines should be established for symptom monitoring, home visits, and interagency communication to ensure continuity of care and reduce relapse.
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