ความคิดเห็นของบุคลากรสาธารณสุขและประชาชนต่อการให้บริการสุขภาพจิตในชุมชน จังหวัดนครราชสีมา / ศิริลักษณ์ แก้วเกียรติพงษ์ = Health personnel's and people's opinion to community mental health service in Nakhon Ratchasima province / Siriluk Kaewkietpong
Background: In the year 2001, 450 millions of world population live with mental illness and in Thailand 1,999, prevalence of mental disorders was shown increasing trend (217.86 per 100,000). Integration of mental health service system was called for more future holistic approach. Hearing from both health providers and clients were crucial step. Objective: To study health personnel's and consumer's opinion toward community mental health service provision in Nakhon Ratchasima province. Research design: Cross-sectional descriptive study Participants: The personnel 713 out of all 1,050 (return 68.0%) and 785 from 817 head of families (participated 96.1%) Data collection: Self-administered questionnaire for health personnel and interview questionnaire for head of family. Statistical Method: Unpaired t-test, One- way ANOVA, Wilcoxon Signed - ranks test, and Mann Whitney U - test. Results: The majority of personnel respondents were female 62.4%, average period of work 23.4 years, position of community health workers and nurses (38.3%, 25.9% respectively), work in health centers 78.1%, and ever trained in mental health 43.1%. More than 50% of personnel respondents rated 20 out of 41 activities in 4 dimensions as highly important activities (4-5 scores) in contrast with only 2 activities rated as highly work amount. Top-3 rank as high important were exercise, promote child development and ageing activities. Further analyses revealed that the important mean scores of 4 dimensions were statistically significant different (p<0.05) by age. For those who had trained experiences in mental health, rated with higher mean scores for the importance than the work amount in all specified activities with statistically significant different (p<0.01). Top-3 critical success factors were stated as comprehensive care, relevancy, and information for planning, and 3 major obstacles were lack of personnel, knowledge, and clear mental service model. Majority of people respondents were female 56.7%, mean age 45.9 years, primary school graduates 82.8%, agricultural workers 67.6%, average income 3,316.2 baht per month with debt 45.4%, never been trained in mental health 90.2%, drug addicts 1.4 % and mental disorders 4.4% in families. More than 50% of family respondents rated all 18 service activities in 4 dimensions as highly important activities, but no highly score found for service activities received. Top-3 important ranking were screening and treatment the addicts and promoting ageing mental health. In comparison the mean scores between personnel and people, higher important scores in all 4 dimensions were marked by people and it is statistically significant different (p<0.01). Conclusion: These findings revealed the 20 high important activities which should be considered as core activities in the guideline for community mental health practice in the future. Reducing the gaps between the high important and low service amount through continuous education for both health personnel and people together with research for developing integrate mental health service in future health service delivery system.