Developing a Model for Caring for Psychiatric Patients in Communities at High Risk of Violence in Phra Nakhon Si Ayutthaya Province

Abstract

This action research aimed to 1) study the context, situation, and challenges in the community-based psychiatric care, 2) develop a community-based care model for psychiatric patients, and 3) evaluate the effectiveness of the developed model. The samples comprised 222 healthcare personnel and 40 psychiatric patients in Phra Nakhon Si Ayutthaya Province. The research instruments consisted of a care model for psychiatric patients at high risk of violence, questionnaires, interviews, and focus group guidelines. Data were analyzed using descriptive statistics and content analysis. The results revealed that:

Phra Nakhon Si Ayutthaya Province is facing an increasing problem of psychiatric patients with a high risk of violence. The developed care model comprised seven steps: 1) psychiatric risk screening, 2) case care planning, 3) follow-up and home visits, 4) empowerment of healthcare teams and families, 5) community participation, 6) plan adjustment, and 7) evaluation. This model resulted in increased health service access for 174 psychiatric patients and improved follow- up rates for 26 patients meeting the specified criteria. The recurrence rate of violent behaviors among patients decreased from 7.27% to 0.77%, while the proportion of patients exhibiting delusions or attempting life-threatening harm to themselves or others was reduced by 1.65%.

It is recommended that public health agencies extend this model to other communities by strengthening healthcare teams, families, and community networks for continuous care and follow-up of psychiatric patients, in order to improve service accessibility, reduce risky behaviors, and clearly lower violence rates.