Navigating the Transition: Assessing Discharge Readiness in Persons With Severe Mental Illnesses in North India
- 1Psychiatry, Institute of Human Behaviour and Allied Sciences, Delhi, IND
- 2Psychiatry, Employees' State Insurance Corporation (ESIC) Hospital, Basaidarapur, Delhi, IND
Abstract
Introduction
Severe mental illnesses (SMIs), including schizophrenia, bipolar disorder, and severe depressive disorders, contribute substantially to the burden of disease and mental health service utilisation in India. Despite this high burden and the critical role of safe care transitions, discharge readiness among psychiatric inpatients has not been systematically studied in India using validated patient-reported measures. This study assesses readiness for hospital discharge among inpatients with SMIs in a tertiary neuropsychiatric hospital in North India using the Readiness for Hospital Discharge Scale (RHDS).
Method
This cross-sectional study was conducted at Institute of Human Behaviour and Allied Sciences (IHBAS), a tertiary neuropsychiatric referral centre in Delhi, India. One-hundred one inpatients diagnosed with SMIs (schizophrenia, schizoaffective disorder, bipolar affective disorder, or severe depressive disorder) as per the International Classification of Diseases, 10th Revision, Diagnostic Criteria for Research (ICD-10 DCR) were recruited through purposive sampling over six months. Discharge readiness was assessed on the planned day of discharge using the Hindi-translated RHDS-Adult Form. Sociodemographic and clinical details were recorded using a semi-structured proforma. Associations were examined using bivariate analyses and logistic regression.
Results
Schizophrenia (47.5%) and bipolar disorder (28.7%) were the most common diagnoses. The mean RHDS score was 7.07 ± 1.08, indicating upper-moderate readiness. Domain scores were highest for coping ability and expected support, intermediate for personal status, and lowest for knowledge. Schizophrenia was significantly associated with lower readiness (p = 0.002) and independently predicted poor discharge readiness (adjusted odds ratio (OR) = 0.13, 95% CI 0.04-0.46). Longer length of stay predicted higher readiness (OR = 1.07/day, p = 0.032).
Conclusion
Despite overall clinical stability at discharge, psychiatric inpatients demonstrated suboptimal readiness, particularly in the knowledge domain, indicating inadequate understanding of illness, treatment, relapse prevention, and follow-up care. The findings underscore the need for structured and standardized discharge planning with strengthened psychoeducation, clear information on community resources and legal rights, and greater involvement of multidisciplinary teams such as social workers or case managers. Tailored discharge interventions may contribute to continuity of care and post-discharge outcomes. Nevertheless, prospective Indian studies are needed to validate its effectiveness and the extent of these benefits.
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BibTeX
@article{saha2026navigating,
title = {{Navigating the Transition: Assessing Discharge Readiness in Persons With Severe Mental Illnesses in North India}},
author = {Rashmita Saha and Garima Bharti and Anadrika Debbarma and Aarushi Aarushi and Nisha Prajapati and Pratibha Gehlawat},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.117404},
url = {https://europepmc.org/article/PMC/PMC13727763},
note = {CC BY},
}
RIS
TY - JOUR
TI - Navigating the Transition: Assessing Discharge Readiness in Persons With Severe Mental Illnesses in North India
AU - Rashmita Saha
AU - Garima Bharti
AU - Anadrika Debbarma
AU - Aarushi Aarushi
AU - Nisha Prajapati
AU - Pratibha Gehlawat
PY - 2026
DA - 2026/10/03
JO - Cureus
DO - 10.7759/cureus.117404
UR - https://europepmc.org/article/PMC/PMC13727763
AB - Introduction Severe mental illnesses (SMIs), including schizophrenia, bipolar disorder, and severe depressive disorders, contribute substantially to the burden of disease and mental health service utilisation in India. Despite this high burden and the critical role of safe care transitions, discharge readiness among psychiatric inpatients has not been systematically studied in India using validated patient-reported measures. This study assesses readiness for hospital discharge among inpatients with SMIs in a tertiary neuropsychiatric hospital in North India using the Readiness for Hospital Discharge Scale (RHDS). Method This cross-sectional study was conducted at Institute of Human Behaviour and Allied Sciences (IHBAS), a tertiary neuropsychiatric referral centre in Delhi, India. One-hundred one inpatients diagnosed with SMIs (schizophrenia, schizoaffective disorder, bipolar affective disorder, or severe depressive disorder) as per the International Classification of Diseases, 10th Revision, Diagnostic Criteria for Research (ICD-10 DCR) were recruited through purposive sampling over six months. Discharge readiness was assessed on the planned day of discharge using the Hindi-translated RHDS-Adult Form. Sociodemographic and clinical details were recorded using a semi-structured proforma. Associations were examined using bivariate analyses and logistic regression. Results Schizophrenia (47.5%) and bipolar disorder (28.7%) were the most common diagnoses. The mean RHDS score was 7.07 ± 1.08, indicating upper-moderate readiness. Domain scores were highest for coping ability and expected support, intermediate for personal status, and lowest for knowledge. Schizophrenia was significantly associated with lower readiness (p = 0.002) and independently predicted poor discharge readiness (adjusted odds ratio (OR) = 0.13, 95% CI 0.04-0.46). Longer length of stay predicted higher readiness (OR = 1.07/day, p = 0.032). Conclusion Despite overall clinical stability at discharge, psychiatric inpatients demonstrated suboptimal readiness, particularly in the knowledge domain, indicating inadequate understanding of illness, treatment, relapse prevention, and follow-up care. The findings underscore the need for structured and standardized discharge planning with strengthened psychoeducation, clear information on community resources and legal rights, and greater involvement of multidisciplinary teams such as social workers or case managers. Tailored discharge interventions may contribute to continuity of care and post-discharge outcomes. Nevertheless, prospective Indian studies are needed to validate its effectiveness and the extent of these benefits.
SN - 2168-8184
ER -