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Despite recognised psychiatric co morbidity, mental health integration in cleft services remains uncommon in LMICs. This study prospectively evaluated a psychiatry-integrated multidisciplinary cleft clinic in a public tertiary hospital in India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Consecutive patients aged\u2009\u2264\u200918\u00a0years attending a psychiatry-integrated multidisciplinary cleft clinic at Goa Medical College (January 2022\u2013September 2024) were prospectively followed for 12\u00a0months. Psychiatric screening was conducted using the Strengths and Difficulties Questionnaire, followed by disorder-specific assessments where indicated, with diagnoses formulated according to ICD-10 criteria. Follow-up continuity was categorised as regular, irregular, or dropout (\u2265\u200990-day lapse). Feasibility and acceptability of the integrated model were assessed using predefined service-delivery indicators and structured caregiver feedback.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 224 registered patients, 210 met the inclusion criteria (mean age 9.8\u2009\u00b1\u20094.3\u00a0years; 56.2% male). Regular, irregular, and dropout follow-up rates were 45.7%, 25.7%, and 28.6%, respectively. Psychiatric comorbidity was identified in 53.3% of participants and was significantly associated with follow-up status (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009), with a higher prevalence among irregular attendees and dropouts. Better follow-up continuity was significantly associated with younger age, higher maternal education, higher socioeconomic status, urban residence, and completion of planned surgical milestones. Speech therapy involvement differed significantly across follow-up groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), with higher engagement among irregular attendees and dropouts, whereas hearing impairment showed no association with follow-up (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.48).From a feasibility perspective, 93.8% of registered patients were enrolled, baseline psychiatric assessment was completed for all participants, and all children with identified psychiatric morbidity received at least one mental health intervention. Caregiver feedback (n\u2009=\u2009150) indicated high satisfaction with integrated care and perceived stigma reduction; dissatisfaction was infrequent (11.3%) and primarily related to logistical barriers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Embedding mental health services within multidisciplinary cleft care is feasible and acceptable in LMIC settings and is associated with improved engagement and continuity of care. Structured psychosocial assessment and coordinated interventions may help address psychiatric morbidity and support sustained participation in cleft care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13034-026-01040-5","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T12:24:50Z","timestamp":1770985490000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Integrating mental health assessment and intervention into cleft care: a prospective cohort study from a tertiary clinic in India"],"prefix":"10.1186","volume":"20","author":[{"given":"Ajay Aditya Aadhi","family":"Mani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aksha","family":"Gaunekar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"issue":"5","key":"1040_CR1","doi-asserted-by":"publisher","first-page":"2621","DOI":"10.4103\/jfmpc.jfmpc_472_20","volume":"9","author":"T Vyas","year":"2020","unstructured":"Vyas T, Gupta P, Kumar S, Gupta R, Gupta T, Singh, et al. 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In accordance with institutional guidelines, written informed consent was obtained from parents or legal guardians for all participants, and assent was obtained from children aged 7\u00a0years and above.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the parents or legal guardians of all participating children and adolescents before enrollment in the study. Age-appropriate assent was also obtained from participants aged 7\u00a0years and above after explaining the study objectives and procedures in a language they understood. The participants and their guardians were assured that participation was voluntary, confidentiality would be maintained, and that refusal to participate would not affect their clinical care.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"38"}}