Seamless and Integrated Emergency Medical Services System for Mental Health Crisis Patients in Thailand

Abstract

Currently, there has been an increasing number of psychiatric patients. From 1 in 5 people in the country to have mental health problems, Thailand has 14.3% or 7 million psychiatric patients at risk of mental health crisis with a chance of inflicting self-harm or violent behaviors towards people and surrounding property. The present research aimed to implement a seamless locally integrated emergency medical service system for emergency mental health crisis patients, monitor, evaluate, and provide policy recommendations. The mixed methods research comprised quantitative and qualitative analysis. The sample group is a multidisciplinary stakeholder in the field of “Emergency Medical Service Systems for Locally Integrated Emergency Mental Health Patients”. The research is conducted in 12 provinces distributed across Health Region 1-12 using a purposive sampling. The tool consisted of a knowledge set, risk evaluation survey, warning sign knowledge assessment form, and questions for the group discussion. The data were analyzed with descriptive statistics and content analysis. The results showed that 1,858 risk groups in 12 pilot sub-districts were mostly male (76.7%), aged 21-50 years (71.4%), with a history of intermittent treatment for psychiatric disorders (43.8%). From these 2,099 relatives/caregivers, most had good understanding on “warning symptoms and requests for help for emergency mental health patients”. As for the self-management community system, most pilot areas had working guidelines before, during, and post treatment, especially on organizing a response team to assess and mitigate before external teams enter the scene. This is connected to the local police unit in conjunction with the initial emergency operations to bring the health service system to the appropriate destination hospital. As an outcome, patients with mental health crises have faster and more access to emergency medical services. In addition, there were no reports of injuries to patients, officer or surrounding people as well as being able to extend the results through the service plan of the Mental Health and Substance Abuse. The
impact for the expected effects, those at risk of mental health crisis can access the health system quickly and appropriately, reducing complications and preventable dangers. In addition, it is expected that the community become more self-reliant, increase in health literacy in promoting, preventing, and providing basic assistance for mental health crisis situation, as well as having established integrated guidelines for the health service system including prevention, pre-hospital care, in-hospital care and inter-facility transfer seamlessly.