Evaluation of Management Process and Achievement of the Integrated Mental Health and Substance Abuse Care System in Ubon Ratchathani Province : An Evaluation Research.

Abstract

      This survey research aimed to assess the context, input, process, product, and outcomes of the management process and effectiveness of the integrated psychiatric and substance abuse care system in Ubon Ratchathani Province. Key informants consisted of 15 strategic executives, 120 psychiatric and substance abuse coordinators, 350 operational personnel, 125 external network partners, 200 patients/caregivers, and 20 experts participating in a public hearing for model development and recommendations. Data were collected using questionnaires, document analysis forms, recording forms, and focus group discussion guides, with all instruments demonstrating content validity (IOC) ranging from 0.80 to 1.00. Data analysis was performed using descriptive statistics, including frequency, percentage, mean, and standard deviation.

      The pre-implementation evaluation revealed that context was at a high level (Mean ± SD = 4.45 ± 0.09), while input was at a moderate level (Mean ± SD = 3.42 ± 0.36). During implementation, process was rated at a high level (Mean ± SD = 4.01 ± 0.11). In terms of product and outcomes, screening coverage reached 87.73% of the total target (4,225 out of 4,816 patients). A total of 4,808 patients entered the treatment system, with a high retention rate of 91.25% (1,689 successfully followed up out of 1,851 patients). Post-implementation findings showed that the sustainability of the "Lom Rak" community was at a high level (Mean ± SD = 4.37 ± 0.08), and satisfaction among patients and caregivers was also high (Mean ± SD = 4.47 ± 0.81). Assessment using the 7-dimension Addiction Severity Index (ASI Short Form) revealed that drug usage was the only dimension in which more than half of the sample exhibited a high cumulative severity level (53.00%). Regarding system outcomes, the majority of patients receiving treatment were male (93.33%; 6,087 out of 6,522 patients), with new patients accounting for over half (56.08%; 3,659 patients) and readmitted patients comprising 43.92% (2,866 patients). Severity classification based on OAS Scores indicated that 84.85% (5,237 patients) were in the green (mild) group, and substance use behavior was predominantly categorized as "abusers" at 76.05% (4,977 patients).