Development of Mental Health and Psychiatric Service Model for Primary Care Units, Sirattana District, Sisaket Province, 2014-2018

Abstract

This study aimed to developed a working model of mental health work and compare the results
before and after the implementation of the model in Sirattana Hospital, Srisaket Province. It was conducted during 1 October 2013 to 30 September 2018 by applying participatory management principles. The samples were all 512 psychiatric patients of the primary care unit of the hospital. Data were
collected by using patient record forms and satisfaction assessment questionnaire; and were analyzed by
descriptive statistics and one sample t-test, at alpha 0.05. The results revealed that after the new working
model implementation, the rate of access to psychiatric services and depression services had increased
(p<0.05); and the rates of default and referring out had decreased (p<0.05); while the recurrence rate
was unchanged. The satisfaction of relatives and caregivers had significantly increased (p<0.05); and
the sevices period has reduced (p<0.05). In addition, the unit cost of services had significantly reduced
(p<0.05). The findings indicated the improvement through the implementation of the new working model
developed by the researcher. Such improvement occurred due to the 4 steps utilyzed in the process of
model development: (1) analysis of the original model, (2) preliminary model development, (3) tesing
of the model, and (4) evaluation and conclusion of the new model development. These activities led to
clear working systems, practicality of model, good preparation and good method of implementation by
the participation of concerning persons from the beginning. Continuous improvement occurred based on
suggestions of implementers covering all related factors. This approach should be applied and extended to
improve the work which would lead to greater benefits for patients, families, communities, and the nation,
both in the short and long term.