Honouring complexity and social justice in mental health: The socio-political economy of global mental health framework.

Cardiovascular diseases are the leading cause of death worldwide, accounting for about 32% of all global deaths and placing a heavy burden on health care systems in terms of cost and loss of productive life [,]. Among patients with severe coronary artery disease, coronary artery bypass grafting (CABG) is the most effective treatment, and it has been shown to significantly improve survival, physical function, and quality of life [-]. The relevance of CABG extends well beyond high-income countries. In India, rapid urbanization, an aging population, physical inactivity, and rising rates of diabetes and hypertension have sharply increased the burden of coronary artery disease over recent decades [-]. As a result, large tertiary cardiac centers in India now perform thousands of CABG surgeries each year. While deaths during and immediately after CABG surgery have decreased significantly due to improvements in surgical technique, anesthesia, and intensive care, patients continue to face serious risks after hospital discharge. The early postdischarge period is particularly vulnerable []. Patients transition from a closely monitored hospital setting to a home environment, where they must manage their own recovery—including wound care, medication management, blood sugar control, and gradual physical activity—simultaneously []. During this period, life-threatening complications such as atrial fibrillation, heart failure, pleural effusion, wound infections, kidney dysfunction, and fluid and electrolyte imbalances can develop quietly, often without obvious warning signs until the patient deteriorates significantly []. Mental health problems also play an important role. Anxiety, depression, poor sleep, and low adherence to medications are common after CABG and can further worsen recovery outcomes []. Many of these early complications and setbacks are potentially preventable if patients and nurses are supported with timely information, symptom monitoring, and early intervention. This gap between hospital discharge and the first follow-up visit is where the greatest opportunity for intervention lies.