Executive Summary. Quantitative data :

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1 Executive Summary An Evaluation of holistic rehabilitation and treatment at Bann Plean Vithee, Moral Development Center, Wang-Noi district, Phranakhon-Si-Ayutthaya province was conducted by ASEAN Institute for Health Development in cooperation with Ministry of Interior. The study aimed to describe outcomes of the project by using CIPP model and to assess the quality of life of the drug addicts who had been treated at the center. Unit cost of the project in 2003 was analyzed as well. Both quantitative and qualitative approaches were used to describe the project success. Summative evaluation were performed with 123 drug addicts in order to assess their present living conditions, family relationship, self-esteems, effect balance scale, problem solving skills, healthy behaviors and recurrent of drug abuse. In-depth interviews, observations and focus group discussion were used for formative evaluation. The samples were 21 drug users attending at Baan Plean Vithee, 1 project director, 4 committee members, 5 volunteers, 12 community people. However, after 4 month of follow-up, 8 patients and their family had given feedback with their self-report. Instruments and tools were modified from standard questionnaires and were pre-tested with 31 patients at Methadone clinic at BMA health Center no.40 in Bangkok Metropolitan. Quantitative data and qualitative data were presented as the following: Quantitative data : 123 cases were participated in the summative evaluation and 44 cases were attending the treatment and rehabilitation course in Structured questionnaires and indepth interviews were employed for the data collection. Recurrent users were verified with Meth-Strip which traced for met-amphetamine and marihuana. The recurrent rate of Met- ช

2 An Evaluation of Holistic Rehabilitation and Treatment for drug addicts project at Baan Plean Vithee, Moral development Center, Wang-Noi District, Phranakhon Si Ayutthaya Province. amphetamine was about 4.9%. However, sleeping pills were also used when they get back to their family at about 10%. When they get back and live in their normal life, most of family had good and improved their relationship. In general, the self-esteems, mental balance score, problemsolving skills, healthy behaviors were satisfied or in a good shape. The most influencing factor was family relationship. There were significant associations between family relationship with self-esteem, effect balance scale, problem solving skills, healthy behaviors. Leaned skills from the center were highly used such as doctrine and discipline. Occupation skill when they learned from the center was used at about 80%. The findings conclude that well-prepared family is important to sustain those patients who had been treated and rehabilitated from Bann Plean Vithee in keeping themselves away from getting back to drug abuse. Unit cost analysis was performed, direct cost of the project in 2003 was about 4.5 million baht and indirect cost was about 0.42 million baht. Forty-four drug addicts who were interviewed was used to estimate the total person-day. The estimate figure was 25,256 person-day. As a result, the unit cost equaled 195 baht person-day. If we assumed that half of 390 clients in 2003 get back and work productively only 6 months. The ratio of income and cost of this project was ซ

3 Qualitative data: Context: Government policy had an influence to the number of patients who attended the rehabilitation center at Wang-Noi district, Ayutthaya province even though there was lacking of involvement of the nearby communities. The process was divided into 4 different phases; a) physical therapy b) detoxification c) mentality rehabilitation and 4) occupational therapy. The whole program mainly emphasized on occupational skill phase which would bring the selfesteems of the patients and the center tried to nourish their mentality and prepare the readiness to get back to their family and society as a new person. Inputs: Financial support was not sufficient to run the program activities. Revolving fund which was mobilized by the project director called Pha Pa (fund raising) as the money was needed. Managerial task and duty were not assigned properly to the tasks and their capability. Decision making needed to be authorized by project director. Process: There was no certain work plan for the project. The protocol of rehabilitation and treatment phases were not implemented as stated especially the time. However, the progress to be moved from one phase to the next phase was judged by the monk s experience. The strength of process was job assigned and duty allocation to the patients during their stay. Product: Most of the patients were involved the drug abuse since they just wanted to try the drug. The center was successfully modified their behavior which were stated as the following indicators; self-esteems, mentality balance score, problem solving skills and their healthy life styles. The chance of getting back to drug abuse was significantly associated to family relationship. ฌ

4 An Evaluation of Holistic Rehabilitation and Treatment for drug addicts project at Baan Plean Vithee, Moral development Center, Wang-Noi District, Phranakhon Si Ayutthaya Province. Recommendations: 1. Temples or religious places would be encouraged to start the holistic rehabilitation center since doctrine and peaceful place will strengthen the patients mind and their spiritual thought. 2. Rehabilitation and treatment phase should be well-documented and implemented in an efficient management and could be served the patients who are in needs. Financial allocation should be funded in time in order to facilitate well in each implementing activities. 3. Addressing the follow-up process. Home visit by monks may reduce the uneasy feeling for those patients who have been treated at the center when they are accepted as new and drug-refrained person in their own community. 4. Promoting the participation of the community themselves. Perception and Participation of local communities nearby was slightly low. Proactive community communications which included all stakeholders need to be done as early as the program start. 5. Arranging knowledge-based learning document for the families readiness to welcome their member back to a warm family relationship, maybe arranging parent s class. 6. Ratio of income and cost for this project was over one and indicated that it is costbenefit project. 7. Better screening with those correctional system clients, because the level of addiction determine period of treatment and rehabilitation. ญ

5 Lesson learned: 1. Problems in quantitative data collection 1.1 Cohort of incoming patients was uncertain and the number was very small when researcher was performing the formative evaluation. 1.2 The study didn t design to collect the different type of the program enrollment. Since it was a sensitive question. The summative evaluation was limited to 123 respondents and voluntarily participated by answering the questionnaire and there were mix-up drug addicts who attended 15 days at most and those who stayed as long as they were ready to leave the center. 1.3 There was no clear line for the time spending in each phase of treatment and based upon the personal judge or experience. 1.4 There were few cases which we could not interview because the brain had been damaged for high dose and longer drug abuse. 1.5 Follow-up was very hard since they had relocated and some of them refused for the interviews. 1.6 Mailing questionnaire is appropriate for the follow-up cases. 2. Problems in qualitative data collection 2.1 There was a difference among Bann Plean Vithee and three others centers in Khon Kean, Surat-thani and Phitsanulok. Those three centers did not fully implement the same treatment and rehabilitation model due to financial support and human resource. 2.2 There was some incorrect information about the contact address for those voluntary coming into the center compared with those coming from correctional system. ฎ