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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0744

Integrated care for pregnant women with substance use disorder: A collaborative model between a psychiatric hospital and public health services in Brazil

INTEGRATED CARE FOR PREGNANT WOMEN WITH SUBSTANCE USE DISORDERS: A COLLABORATIVE MODEL BETWEEN A PSYCHIATRIC HOSPITAL AND PUBLIC HEALTH SERVICES IN BRAZIL

Pregnant psychiatric patients with substance use disorder present with highly complex clinical and social needs, and psychiatric hospitalization provides a critical window for re-engagement with prenatal care.

The aim is to describe an integrated care model for pregnant psychiatric inpatients with substance use disorder (SUD), emphasizing intersectoral coordination, prenatal care, and perinatal planning, and to illustrate the clinical and social complexity of this population. The method is a descriptive review of a specialized inpatient care pathway and ongoing institutional monitoring reports at a psychiatric hospital in Brazil over the 28-month period from April 2024 to July 2026; of 60 pregnant psychiatric inpatients, 47 with documented SUD constituted the primary analysis sample. The model brings together psychiatry, nursing, social work and social protection, obstetrics, serological screening and treatment for sexually transmitted infections, child protection and judicial services, and community-based primary health care within a four-stage pathway (admission and assessment, integrated inpatient care, delivery and transition planning, and postpartum and discharge planning). The findings show that 93.6% of admissions (44/47) were involuntary or compulsory; pregnancy was first identified during admission in 10.6% of cases (5/47), and current or past syphilis was documented in 29.8% (14/47). Of the patients, 91.5% (43/47) were involved with community mental health services, 46.8% (22/47) with social protection services, and 53.2% (25/47) with child protection and/or judicial proceedings; the median age was 27 years, and the median gestational age at admission was 21 weeks. According to the latest records, substance use follow-up was planned for 90.5% (38/42) of the 42 women who had been discharged; after discharge, relapse or a return to substance use was documented in 21.1% (8/38), and a return to homelessness in 10.5% (4/38). The discussion notes that psychiatric hospitalization creates a critical window for stabilizing severe illness, reconnecting women with prenatal care, and coordinating maternal and neonatal safeguarding, while ongoing relapse and social vulnerability after discharge reinforce the need for network-based integrated follow-up. Limitations included the retrospective review of routine institutional monitoring records, missing or inconsistent data for some variables and dates, the absence of a comparison group, and the ascertainment of post-discharge outcomes from routine follow-up notes rather than standardized measures.

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