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ECCMH Thailand

Community Mental Health Service

Community mental health services (CMHS), also known as Community Mental Health Teams (CMHT), support or treat people with mental disorders (mental illness or mental health difficulties) in a domiciliary setting, instead of a psychiatric hospital . The array of community mental health services vary depending on the country in which the services are provided. It refers to a system of care in which the patient's community, not a specific facility such as a hospital, is the primary provider of care for people with a mental illness.

The goal of community mental health services often includes much more than simply providing outpatient psychiatric treatment.[1] Community services include supported housing with full or partial supervision (including halfway houses), psychiatric wards of general hospitals (including partial hospitalization), local primary care medical services, day centers or clubhouses, community mental health centers, and self-help groups for mental health.

The services may be provided by government organizations and mental health professionals, including specialized teams providing services across a geographical area, such as assertive community treatment and early psychosis teams. They may also be provided by private or charitable organizations. They may be based on peer support and the consumer/survivor/ex-patient movement. The World Health Organization states that community mental health services are more accessible and effective, lessen social exclusion, and are likely to have less possibilities for the neglect and violations of human rights that were often encountered in mental hospitals.

Key principles for balanced community-based mental health services

Autonomy: a patient’s ability to make independent decisions and choices, despite the presence of symptoms or disabilities. Autonomy should be promoted by effective treatment and care.

Continuity: the ability of relevant services to offer interventions that are either coherent over the short term both within and among teams (cross-sectional continuity), or are an uninterrupted series of contacts over the long term (longitudinal continuity).

Effectiveness: the ability to provide the proven, intended benefits of treatments and services in real-life situations.

Accessibility: patients’ ability to receive care where and when it is needed.

Comprehensiveness: a service characteristic with two dimensions. Horizontal comprehensiveness means the extent to which a service is provided across the entire range of mental illness severity, and the wide range of patient characteristics. Vertical comprehensiveness means the availability of the basic components of care, and their use by prioritized groups of patients.

Equity: the fair distribution of resources. Both the rationale used to prioritize competing needs and the methods used to allocate resources should be explicit.

Accountability: the answerability of a mental health service to patients, their families and the wider public, all of whom have legitimate expectations of how such a service should carry out its responsibilities.

Coordination: a service characteristic resulting in coherent treatment plans for individual patients. Each plan should have clear goals and necessary and effective interventions, no more and no less. Crosssectional coordination means the coordination of information and services within an episode of care. Longitudinal coordination means the interlinkages among staff members and agencies over a longer period of treatment.

Efficiency: minimizing the inputs needed to achieve a given level of outcomes, or maximizing the outcomes for a given level of inputs.

Best Practice of Community Mental Health Care Service in Aria Health Board No 9 th.

       ( 1 ) Wang Nam Kheaw Model ( Wat Hua Phrom ) : Psychiatric recovery rehabilitation system in community
       ( 2 ) Serng Sang School Model : prevention program of teenage pregnancy ( prevention program )

Updated : 13 March 2016



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