Development of Care Model for Serious Mental illness High Risk to Violence (SMIV) with Social Mobilization Together with Case Management in Mueang District, Maha Sarakham Province

Abstract

Objectives : 1) To assess the situation of care for Serious Mental illness High Risk to Violence (SMIV) in Mueang District, Maha Sarakham Province; 2) Develop a comprehensive care model for these patients; and 3) Evaluate its effectiveness. Research Design and

Methods : This study employed a participatory action research (PAR) approach from January 2022 to April 2024. The study involved 151 participants, including serious mental illness high risk to violence, their relatives or caregivers, community leaders, law enforcement officers, prison staff, local administrative representatives, monks, healthcare professionals, and multidisciplinary teams from Maha Sarakham Hospital and its network. Data were collected using mixed methods: quantitative data were analyzed using descriptive statistics (frequencies and percentages), while qualitative data were analyzed using thematic content analysis.

Results : 1) The number of serious mental illness high risk to violence in Mueang District, Maha Sarakham, increased during 2021-2022. There was a lack of an integrated care model connecting initial care to continuous community care. 2) The developed care model was created through situation analysis, coordination with the District Narcotics Control Committee, stakeholder meetings, planned activities, and iterative problem-solving across three cycles. The final model combined social mobilization with case management, including pre-hospital care ("Three Doctors" approach - collaboration between doctors in hospitals, community, and traditional healers), in-hospital care, and post-hospital care. 3) By 2024, 98.97% of these patients were effectively managed without recurrent violent incidents.

Conclusion : A care model for serious mental illness high risk to violence, using social mobilization and case management, is an effective tool to ensure appropriate screening, referral, treatment, and follow-up care.