Development of a Care Model for Substance use Patients with Mental Disorders and Aggressive Behavior in Lomkao Crown Prince Hospital

Abstract

Background: Substance use in patients with mental disorders and aggression poses significant challenges to
care quality and safety. However, a critical gap exists regarding integrated care models to overcome the lack of
coordinated care from various departments. This study aimed to develop and evaluate a comprehensive care
model for substance use patients with mental disorders and aggressive behavior.
Methods: A randomized control trial (RCT) was employed, with 80 participants randomly assigned to intervention
(n=40) or control (n=40) groups from May 2025 to October 2025 through structured questionnaires. The intervention
group received an integrated care model and post-discharge monitoring via the LINE application. Outcomes were
measured using the Overt Aggression Scale (OAS) and adherence at baseline and 4-month follow-up. A mixedeffects
linear regression model was used to assess the effect of the intervention on OAS scores over time while
chi-square tests were used to compare categorical variables. t-tests were used to compare continuous variables.
Results:At baseline, there was no significant difference between the intervention and control groups. A significant
reduction in OAS scores from baseline to 4-month follow-up (β = -35.800, p < 0.001). While the group×time
interaction was statistically significant (β = 13.500, p < 0.001).Post-discharge adherence was higher in the
intervention group, including LINE tracking (82.5%), medication adherence (77.5%), and appointment reminders
and attendance (87.5%) (p < 0.001).
Conclusion: The integrated care model significantly improved outcomes for substance use patients with mental
disorders and aggressive behavior. Its success highlights the importance of interdisciplinary collaboration, staff
training, and digital follow-up systems. The model offers a scalable solution for similar settings.