The Systematic Management towards Development of Mental Health Services : “Near Home, Near Heart, In the Community”, Nonsung District, Nakhon Ratchasima Province

Abstract

The purpose of this participatory action research was to study the management of the mental health service development system in Non Sung district, Nakhon Ratchasima province using the model: "Near Home, Near Heart, In the Community" implemented during Oct. 2017 and Sep. 2021. It was divided into 3 phases. Phase 1-preliminary phase was consisted of study of the context of the area and analysis of mental and psychiatric problems and related factors. Phase 2,-action phase was consisted of planning and Implementation of the action plan. Phase 3:-monitoring and evaluation with systematic management by bringing information on problems in caring for psychiatric patients as input and planning to develop the potential for mental health and psychiatric care for sub-district health promoting hospitals (SDHPH), develop a mental health service model of NODE in SDHPH, develop the potential of personnel both inside and outside of health network, support P4P money for SDHPH, organize LAB system in SDHPH, and supporting psychological tools for mental health patient care. The adjustments of psychiatric clinic to psychosocial clinic using the F-C-T conceptual framework for mental health and psychiatric operations. Goals were for set as indicators for monitoring and evaluation including 1) SDHPH provided psychosocial clinic services, 2) improving access to mental health and psychiatric services, 3) improving quality of life among stabled psychiatric patients to be able to live in the society, 4) reducing missed appointments and lack of medication rates, and 5) improving service satisfaction. Results showed that 18 out of 18 SDHPH (100%) provided psychosocial clinic services. During the fiscal year of 2560-2564 BE, access to psychiatric services increased by 82.00, 82.90, 89.30, 90.50 and 92.35 percent; access to depression services increased by 56.19, 66.05, 67.08, 72.36 and 89.28 percent; access to ADHD services increased 10.75, 11.03, 15.42, 24.31 and 28.67 percent, quality of life among psychiatric patients was at a good level, calm, able to carry out daily life at 98.15, 98.30, 97.78, 99.28 and 99.82 percent; rate of missed/lack of medication reduced by 0.48, 0.72, 0.39, 0.24 and 0.18 percent, and satisfaction rate of service recipients towards the service system arrangement increased to 88.32, 89.20, 90.00, 91.22 and 92.30 percent, respectively.