Evaluation of Telepsychiatry for Psychiatric care In Prisoner, Rattanaburi District Prison

Abstract

Background: Incarcerated individuals are unable to access public healthcare services independently, creating a barrier to equitable mental health care. In response, Rattanaburi Hospital developed a Tele-psychiatry system to support mental health and psychiatric care within the prison, aligning with principles of human rights and healthcare equity.
Objective: To evaluate the organization and clinical outcomes of the Tele-psychiatry system for inmates at Rattanaburi District Prison, based on the World Health Organization’s Six Building Blocks of Health System framework.
Method: This evaluation research employed a purposive sampling approach. Participants included 16 healthcare providers at Rattanaburi Hospital, 4 prison healthcare officers, and 156 inmates diagnosed with mental health problems from a total of 1,639 screened cases. Data were analyzed using descriptive statistics.
Results: Mental health issues were found in 9.5% of screened inmates, with 2.2% diagnosed with psychiatric disorders. Of 119 inmates with depressive symptoms, 78.6% were mild, 17.9% moderate, and 3.5% severe. Post-implementation outcomes showed no incidents of psychiatric violence, with only 5.2% experiencing adverse drug reactions. At 6-month follow-up, 95.8% of inmates had normal mental health screening results. System limitations included internet connectivity and data recording issues.
Conclusions: The Telepsychiatry model improved access to mental health services in prison settings, providing continuous, effective, and equitable care. Further system enhancements are needed to address technical barriers and optimize long-term use.