A pilot randomized controlled trial to evaluate the efficacy of transitional care interventions to improve mental health outcomes using a continuity of care approach for individuals with severe mental illness

This feasibility study utilized two-arm, single-blind randomized controlled trial (RCT), conducted in a psychiatry unit of a tertiary care institution between February 2021 and January 2022. Seventy-two individuals with Severe Mental Illnesses (SMI) screened for eligibility, of which 44 were randomly assigned to receive transitional nursing care intervention (TNC, n = 22) or the treatment as usual (TAU, n = 22). Participants of both groups were initially assessed for symptom severity, medication adherence, functional ability, and process of recovery. TNC participants received six sessions of transitional nursing care interventions (TNCI) including home visit and telephonic booster intervention after discharge along with standard routine care at inpatient psychiatric unit. TAU group participants received only standard routine care. Post-intervention outcome variables were assessed at the first, second, and third months. Results showed that majority (91%) participants attended all six TNCI sessions. We observed that post-intervention, participants in the TNC group reported a significant reduction in symptom severity and improvement in medication adherence, functional ability, and process of recovery, compared to the TAU group with large effect sizes. TNCI led to improve mental health outcomes for SMI subgroups during the transition between inpatient to community or home settings. This study provides preliminary support for the hypothesis that implementing transitional nursing care interventions is feasible in individuals with severe mental illness. Trial registration No. CTRI/2020/12/029998, registered on: 23/12/2020.