Transitions of care from child and adolescent mental health services to adult mental health services (TRACK Study) : a study of protocols in Greater London
Singh, Swaran P., Paul, Moli, Ford, Tamsin, Kramer, Tami and Weaver, Tim (2008) Transitions of care from child and adolescent mental health services to adult mental health services (TRACK Study) : a study of protocols in Greater London. BMC Health Services Research, Vol.8 . Article 135. ISSN 1472-6963 Official URL: http://dx.doi.org/10.1186/1472-6963-8-135 AbstractBackground: Although young people's transition from Child and Adolescent Mental Health
Services (CAMHS) to Adult Mental Health Services (AMHS) in England is a significant health issue
for service users, commissioners and providers, there is little evidence available to guide service
development. The TRACK study aims to identify factors which facilitate or impede effective
transition from CAHMS to AMHS. This paper presents findings from a survey of transition
protocols in Greater London.
Methods: A questionnaire survey (Jan-April 2005) of Greater London CAMHS to identify
transition protocols and collect data on team size, structure, transition protocols, population
served and referral rates to AMHS. Identified transition protocols were subjected to content
analysis.
Results: Forty two of the 65 teams contacted (65%) responded to the survey. Teams varied in
type (generic/targeted/in-patient), catchment area (locality-based, wider or national) and transition
boundaries with AMHS. Estimated annual average number of cases considered suitable for transfer
to AMHS, per CAMHS team (mean 12.3, range 0–70, SD 14.5, n = 37) was greater than the annual
average number of cases actually accepted by AMHS (mean 8.3, range 0–50, SD 9.5, n = 33).
In April 2005, there were 13 active and 2 draft protocols in Greater London. Protocols were largely
similar in stated aims and policies, but differed in key procedural details, such as joint working
between CAHMS and AMHS and whether protocols were shared at Trust or locality level. While
the centrality of service users' involvement in the transition process was identified, no protocol
specified how users should be prepared for transition. A major omission from protocols was
procedures to ensure continuity of care for patients not accepted by AMHS.
Conclusion: At least 13 transition protocols were in operation in Greater London in April 2005.
Not all protocols meet all requirements set by government policy. Variation in protocol-sharing
organisational units and transition process suggest that practice may vary. There is discontinuity of
care provision for some patients who 'graduate' from CAMHS services but are not accepted by
adult services. | Item Type: | Journal Article |
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| Subjects: | B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services |
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| Divisions: | Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Child mental health services, Mental health services -- Teenagers -- Great Britain |
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| Journal or Publication Title: | BMC Health Services Research |
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| Publisher: | BioMed Central |
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| ISSN: | 1472-6963 |
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| Date: | 23 June 2008 |
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| Volume: | Vol.8 |
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| Page Range: | Article 135 |
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| Status: | Peer Reviewed |
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| Access rights to Published version: | Open Access |
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| References: | 1. Reder P, McClure M, Jolley A: Interface between child and adult
mental health. In Family matters: interface between child and adult
mental health Edited by: Reder P, McClure M, Jolley A. London ,
Routledge; 2000:3-20.
2. Bradley S, Kramer T, Garralda E, Bower P, MacDonald W, Sibbald B,
Harrington R: Child and adolescent mental health interface
work with primary services: a survey of NHS provider trusts.
Child and Adolescent Mental Health 2003, 8:170-176.
3. Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, etal: Age of
onset of mental disorders: a review of recent literature. Current
Opinion in Psychiatry 2007, 20(4):359-364.
4. American Academy of P, American Academy of Family P, American
College of Physicians-American Society of Internal M: A Consensus
Statement on Health Care Transitions for Young Adults
With Special Health Care Needs. 2002, 110(6):1304-1306.
5. DOH: National Service Framework for Children, Young People
and Maternity Services: the mental health and psychological
well-being of children and young people: standard 9.
London , Department of Health, Department for Education and Skills;
2004.
6. Upper and lower age limit of CAMHS provision [http://
www.camhsmapping.org.uk/2005/reports]
7. Singh SP, Evans N, Sireling L, etal: Mind the gap: the interface
between CAMHS and adult services. Psychiatric Bulletin 2005,
29:292-294.
8. DOH: Every child matters, change for children. London ,
Department of Health; 2004.
9. DfES: Youth matters: next steps. London , Department for Education
and Skills; 2006.
10. HASCAS: CAMHS to adult transition. HASCAS tools for
transition. A literature review for informed practice. London
, Health and Social Care Advisory Service; 2006.
11. Commission for Health Improvement [http://www.chi.nhs.uk/
Ratings/]
12. DOH, DfES: Transition: getting it right for young people. London
, Department for Education and Skills, Department of Health;
2006.
13. AuditCommission: Children in mind. London , Audit Commission;
1999.
14. Davis M, Sondheimer DL: State child mental health efforts to
support youth in transition to adulthood. Journal of Behavioural
Health Services and Research 2005, 32:27-42.
15. McGorry P: The specialist youth mental health model:
strengthening the weakest link in the public mental health
system. Med J Aust 2007, 187(7 Suppl):s53-6.
16. MHF: Bright futures: promoting children and young people's
mental health. London , Mental Health Foundation; 1999.
17. DOH: Getting the right start: the National Service Framework
for Children, Young People and Maternity Services -
emerging findings. London , Department of Health; 2003.
18. DOH: National Service Framework for Mental Health: modern
standards and service models. London , Department of
Health; 1999.
19. DOH: Effective care co-ordination in mental health services:
modernising the care programme approach - a policy booklet.
London , Department of Health; 1999.
20. GillettG: The mind and its discontents. Oxford , Oxford University
Press; 1999.
21. Kendell R, Jablensky A: Distinguishing between the validity and
utility of psychiatric diagnoses. American Journal of Psychiatry
2003, 160:4-12.
22. SroufLA: Considering normal and abnormal together: the
essence of developmental psychopathology. Development and
Psychopathology 1990, 2:335-347.
23. Goodman R: Child and Adolescent Mental Health Services:
Reasoned Advice to Commissioners and Providers. In Maudsley
Discussion Paper no 4 London , King's College; 2005.
24. CAMHS child and adolescent mental health service mapping
[http://www.dur.ac.uk/camhs.mapping/]
25. DOH: Framework for the assessment of children in need and
their families. London , Department of Health, Department for
Education and Employment and Home Office; 2000. |
|---|
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