EMERGENCY PATIENTS WITH MENTAL CRISIS ACCESSING EMERGENCY MEDICAL SERVICES IN THAILAND

Abstract

Objective: To study the situation and barriers of accessibility to the emergency medical services (EMS) and appropriate treatment for patients with mental crisis in Thailand.

Methods: This study employed mixed method research design. The sample included 26,511 mental crisis patients using EMS and stakeholders from four provinces from each region, 35 stakeholders for each province. Data of mental crisis patients were extracted from the Information Technology for Emergency Medical System between 2014-2016 and Data of stakeholders were from focus group and in-depth interview. The data were analyzed using descriptive statistics and content analysis.

Results: The number of emergency patients with mental crisis accessible to emergency medical services were increasing for the past 3 years. Most patients are male, in working age, and from the Northeastern during the raining and winter season, especially between September and October. During a mental crisis, family and community will ask for assistance from the police and the emergency units. Since appropriate practice guideline was not available, so response was depended on the experience and capability of community. The emergency operation teams in every level has insufficient knowledge and skills to care for these mental crisis patients. Psychiatric hospitals have different criteria for admitting the patients. Most hospitals did not have fast-track system and sometimes even refuse to admit the patients. The development of cooperation among the mental health hotline (1323), the police (191), and the emergency unit (1669) is still a challenge. In addition, the development of a fast-track network connecting the community to hospitals will ensure caregivers and community that supporting resources will be available when needed.

Conclusion: The number of mental crisis patients with EMS were rising. However, still an issue. Most hospitals lack prioritized access and most staffs had insufficient knowledge and skills. Cooperation among the police, emergency operation team and the psychiatric team is still a challenge.