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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO472

Community-based recovery with 67% remission: implementation fidelity to the 3-4-5 principle

COMMUNITY-BASED RECOVERY WITH 67% REMISSION: IMPLEMENTATION FIDELITY OF THE 3-4-5 PRINCIPLE

A community-based recovery model implemented with high fidelity to the structured 3-4-5 principle achieved a remission rate of 67.52% at six months and cost substantially less than hospital-based care.

The study aimed to evaluate the implementation of the Community Based Recovery Extended (CBRx) model for people who use substances using the RE-AIM framework, with particular emphasis on implementation fidelity and six-month remission. A mixed-methods implementation study was conducted; the model was implemented according to the principle of three foundations (risk hotspot mapping, spiritual anchoring, family ties), four areas of development (youth prevention, rapid referral, volunteers, vocational pathways), and five stakeholders (district health board, law enforcement, healthcare personnel, local leaders, families); outcomes were reach, effectiveness, adoption, implementation, maintenance, and cost. In terms of reach, 318 practitioners were trained, 393 participants with substance use disorders were enrolled in the program, and 711 people were reached directly or indirectly; in terms of adoption, 12 districts developed implementation plans, and trainees' knowledge scores increased from 6.13 to 8.10. Implementation took place in 57 communities, exceeding the target of 36; 29 were classified as having implementation fidelity and 28 as lacking fidelity. At six months, remission rates were 67.52% (95% CI 60.19 to 74.84) in communities with implementation fidelity and 16.53% (95% CI 11.79 to 21.26) in communities without fidelity (p < 0.01); at three months, these rates were 35.03% and 8.47%, respectively. The community mental health (CMH) index increased from 93.89 to 101.52 (mean difference +7.63; p < 0.01), and 100% of participating provinces continued the program beyond the formal study period; the mean operating cost was THB 12,114.25 per village (approximately USD 361), while the conference abstract reported a total cost, including training, of THB 52,829.25 per village and a cost of THB 29,718 per person for hospital-based care. The authors state that, when implemented with fidelity, this structured community-based recovery tool can achieve remission in approximately two-thirds of participants and is scalable.

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