The Development of an Integrated Medical Services Model for Mental Crisis Patients in Rayong Province

Abstract

This action research aimed to study the current situation, problems, and solutions to develop and evaluate an integrated medical service model for patients with mental health crises. Data were collected through document analysis, questionnaires, in-depth interviews, and focus group discussions in Wang Chan and Ban Chang Districts, Rayong Province. Both districts prioritized emergency care, referral, and treatment systems for mental health crisis patients. Preventive measures involved community health volunteers and leaders monitoring psychiatric patients, emphasizing warning signs before mental disturbances using the OAS assessment, and primary care units providing mentorship. During crises, coordination occurred at community levels, via hotlines 191 and 1669, for joint operations, patient transfers to emergency rooms, and crisis management in hospitals. Community self-management strategies included monitoring high-risk groups, establishing help request procedures for patients exhibiting disturbed behavior, educating families and caregivers on recognizing warning signs, ensuring medication adherence through home visits, integrating community-based treatment (CBTx), and sustainable community projects. Multidisciplinary teams empowered high-risk groups to avoid relapsing into substance abuse through close monitoring, video calls for counseling and encouragement by nursing counselors, especially for those at high relapse risk.