Development and Implementation of Proactive Integrated Mental Health Care Model for Hospitalized Surgical Patients: Quasi-Experimental Trial from North-East India

Rationale of the research: Mental Health disorders (MHDs) have a significant impact on surgical

outcomes such as increased post-surgical pain, hospital length of stay, complications, readmissions, and

mortality. Western countries have developed a proactive consultation-liaison (C-L) psychiatry model for

the early detection and management of psychiatric issues among surgical inpatients. Despite the fact

that proactive C-L service models are superior to traditional care models, no model has been developed

and evaluated for its effectiveness, and feasibility in Indian healthcare settings. This study will be

planned to develop and Implement the Proactive Integrated Mental Health Care (PIMHC) Model for

Hospitalized Surgical Patients. Methods: The quasi-experimental study (A1-B-A2 design) study, will be

carried out in AIIMS Guwahati for a period of 2 years. After brief training, surgical nurses will screen

the patients admitted to surgical wards for psychiatric issues. The surgical inpatient with MHDs with

an age of more than 18 years, either gender will be intervened using a PIMHC model (intervention

period) or consultation as a usual model (CAU model). Outcomes (length of stay. consultation latency,

consultation rate, MERIT, ASSIST, and GHQ-28 score) will be assessed 2-3 weeks after the admission in

surgical wards (Primary end-point). The secondary endpoints will be changes in MERIT, ASSIST, and

GHQ-28 scores at 6 and 8 weeks. Expected outcome: The PIMHC model could be effective, feasible, and

promising for surgical inpatients with MHD in terms of early detection and prompt management.

Furthermore, the model may help to reduce hospital stays by addressing the existing barriers within

Indian settings. The effective model could be scaled-up in nonsurgical settings as well as secondary or

tertiary care settings in the future.