The Development of a Care Model for Psychiatric Patients with Substance Use and Violence Risk, Kham Muang District, Kalasin Province

Abstract

             This action research aimed to develop and evaluate a care model for substance-induced psychiatric patients exhibiting violent behavior within the context of Kham Muang District, Kalasin Province. The study emphasized the importance of community-based participation and collaboration among network partners. The research process followed the action research framework of Kemmis and McTaggart, comprising situational analysis, model development, implementation, and reflection. The sample consisted of 26 participants, including psychiatric patients with substance use issues and their caregivers. Research instruments included the Psychiatric Violence Screening Scale (PVSS), the Brief Psychiatric Rating Scale (BPRS), the 8-Question Suicide Risk Assessment (8Q), a community care follow-up form, and a caregiver burden assessment. Data were analyzed using descriptive statistics and pre-post comparison.

              The results indicated that the developed care model consisted of five key components: 1) risk screening and assessment; 2) continuous care and rehabilitation in the community; 3) multidisciplinary team engagement; 4) integration of network partners and the community; and 5) a monitoring, surveillance, and referral system. These components functioned as an interconnected care ecosystem. Post-implementation findings revealed a declining trend in the levels of violence risk, psychiatric symptoms, and suicide risk among patients. Concurrently, community care outcomes showed improvement, while the caregiver burden demonstrated a decreasing trend. These findings demonstrate the potential of this care model for application at the community level within the primary health care context. By leveraging the integration of multidisciplinary teams and community networks, the model promotes the continuity and sustainability of long-term care.