Evaluation of the Mini-Thanyarak Service Project in Thailand

Abstract

This research is an evaluation study aimed at examining the performance of the Mini-Tanyarak service model in Thailand, along with identifying the risks and problems in its implementation. The samples were 110 personnel serving as coordinators for the Mini-Tanyarak services in hospitals under The Office of the Permanent Secretary of the Ministry of Public Health. The research instrument was a questionnaire developed by the researchers, which was validated by experts. Data were analyzed by using Frequency distribution, Percentages, Means, and content analysis. The findings indicate that there are a total of 1,844 service beds across 110 health service areas in Thailand, with 1,040 designated for intermediate care and 804 for long-term care. The healthcare workforce includes full-time doctors and nurses in 68 facilities, and full-time nurses in 82 facilities. Various training programs have been implemented for medical staff, including courses on Mini-Tanyarak, substance abuse medicine for doctors, and specialized training. A total of 2,638 patients have been treated, with 2,298 in intermediate care and 340 in long-term care. The most frequently abused substances are Methamphetamine and Ice. An assessment of patient severity using the OAS scale revealed that most patients fall into the yellow severity category. Significant risks identified in service provision include patients absconding from the treatment facility and incidents of violence. The study also identified several Problems and obstacles in service delivery, such as staff shortages, inadequate facilities, insufficient budgets, and a lack of clarity in the patient referral system. Recommendations from the research suggest that The Office of the Permanent Secretary should establish a clear structure for Mini-Tanyarak services, define personnel staffing requirements, and clarify roles and responsibilities. Adequate budget allocation should be made to improve and sustain service processes. The Department of Medical Services and the Department of Mental Health should prioritize comprehensive training for personnel to enhance their expertise in necessary service areas. The National Health Security Office should develop more efficient reimbursement system for the treatment of substance-related mental health patients.