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

Background: Substance use in patients with mental disorders and aggression poses significant challenges tocare quality and safety. However, a critical gap exists regarding integrated care models to overcome the lack ofcoordinated care from various departments. This study aimed to develop and evaluate a comprehensive caremodel 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 interventiongroup received an integrated care model and post-discharge monitoring via the LINE application. Outcomes weremeasured using the Overt Aggression Scale (OAS) and adherence at baseline and 4-month follow-up. A mixedeffectslinear regression model was used to assess the effect of the intervention on OAS scores over time whilechi-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 significantreduction in OAS scores from baseline to 4-month follow-up (β = -35.800, p < 0.001). While the group×timeinteraction was statistically significant (β = 13.500, p < 0.001).Post-discharge adherence was higher in theintervention group, including LINE tracking (82.5%), medication adherence (77.5%), and appointment remindersand attendance (87.5%) (p < 0.001).Conclusion: The integrated care model significantly improved outcomes for substance use patients with mentaldisorders and aggressive behavior. Its success highlights the importance of interdisciplinary collaboration, stafftraining, and digital follow-up systems. The model offers a scalable solution for similar settings.