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Process, outcome and experience of transition from child to adult mental healthcare : multiperspective study

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Singh, Swaran P., Paul, Moli, Ford, Tamsin, Kramer, Tami, McLaren, Susan, Hovish, Kimberly, Islam, Zoebia, Belling, Ruth and White, Sarah. (2010) Process, outcome and experience of transition from child to adult mental healthcare : multiperspective study. British Journal of Psychiatry, Vol.197 (No.4). pp. 305-312. ISSN 0007-1250

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Official URL: http://dx.doi.org/10.1192/bjp.bp.109.075135

Abstract

Background Many adolescents with mental health problems experience transition of care from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS). Aims As part of the TRACK study we evaluated the process, outcomes and user and carer experience of transition from CAMHS to AMHS. Method We identified a cohort of service users crossing the CAMHS/AMHS boundary over 1 year across six mental health trusts in England. We tracked their journey to determine predictors of optimal transition and conducted qualitative interviews with a subsample of users, their carers and clinicians on how transition was experienced. Results Of 154 individuals who crossed the transition boundary in 1 year, 90 were actual referrals (i.e. they made a transition to AMHS), and 64 were potential referrals (i.e. were either not referred to AMHS or not accepted by AMHS). Individuals with a history of severe mental illness, being on medication or having been admitted were more likely to make a transition than those with neurodevelopmental disorders, emotional/neurotic disorders and emerging personality disorder. Optimal transition, defined as adequate transition planning, good information transfer across teams, joint working between teams and continuity of care following transition, was experienced by less than 5% of those who made a transition. Following transition, most service users stayed engaged with AMHS and reported improvement in their mental health. Conclusions For the vast majority of service users, transition from CAMHS to AMHS is poorly planned, poorly executed and poorly experienced. The transition process accentuates pre-existing barriers between CAMHS and AMHS

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Mental Health and Wellbeing Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Teenagers -- Mental health services -- Great Britain
Journal or Publication Title:	British Journal of Psychiatry
Publisher:	Royal College of Psychiatrists
ISSN:	0007-1250
Date:	22 October 2010
Volume:	Vol.197
Number:	No.4
Page Range:	pp. 305-312
Identification Number:	10.1192/bjp.bp.109.075135
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	National Institute for Health Research (Great Britain) (NIHR)
References:	1. Royal College of Paediatrics and Child Health. Bridging the gaps: health care for adolescents. 2003 11 October 2007]; Available from: www.rcpch.ac.uk. 2. Lamb, C., et al., Working at the CAMHS/Adult Interface: Good practice guidance for the provision of psychiatric services to adolescents/young adults. A joint paper from the Interfaculty working group of the Child and Adolescent Faculty and the General and Community Faculty of the Royal College of Psychiatrists, May 2008, C. Lamb, Editor. 2008. 3. Singh, S.P., Transition of care from child to adult mental health services: the great divide. Current Opinion in Psychiatry, 2009. 22(4): p. 386-390. 4. Forbes, A., et al. A multi-method review to identify components of practice which may promote continuity in the transition from child to adult care for young people with chronic illness or disability. Report for the National Coordinating Centre for NHS Service Delivery and Organisation R & D (NCCSDO) 2002; Available from: www.sdo.lshtm.ac.uk. 5. While, A., et al., Good practices that address continuity during transition from child to adult care: synthesis of the evidence. Child: Care, Health and Development, 2004. 30(5): p. 439-452. 6. Kennedy, A., et al., Young people with chronic illness: the approach to transition. Internal Medicine Journal, 2007. 37(8): p. 555 - 560. 7. Department for Children Schools and Families and Department of Health, Transition: moving on well. A good practice guide for health professionals and their partners on transition planning for young people with complex health needs or a disability. 2008, Department of Health: London. 8. Department of Health, Good transitions for good people. 2006, Department of Health: London. 9. American Academy of Pediatrics, American Academy of Family Physicians, and American College of Physicians-American Society of Internal Medicine, A consensus statement on health care transitions for young adults with special health care needs. Pediatrics, 2002. 110: p. 1304-1306. 10. Blum, R., et al., Transition from child-centered to adult health-care systems for adolescents with chronic conditions: a position paper for the Society of Adolescent Medicine. Journal of Adolescent Health, 1993. 14: p. 570–576. 11. McDonagh, J.E. and D.A. Kelly, Transiting care of the pediatric recipient to adult care givers. Pediatric Clinic of North America, 2003. 50: p. 1561-1583. 12. Royal College of Nursing, Adolescent transition care. 2004, London: RCN Publications. 13. Vostanis, P., Patients as parents and young people approaching adulthood: how should we manage the interface between mental health services for young people and adults? Current Opinion in Psychiatry, 2005. 18(4): p. 449-454. 14. Commission for Health Improvement. Transition of care between CAMHS and adult services. 2003; Available from: www.chi.nhs.uk. 15. Department of Health, Getting the right start: national service framework for children: emerging findings. 2003, Department of Health: London. 16. Department for Education and Skills, Every child matters: change for children. 2004, Department for Education and Skills: London. 17. Department of Health and Department for Education and Skills, National service framework for children, young people and maternity services. 2004, Department of Health, Department for Education and Skills: London. 18. Singh, S.P., et al., 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, 2008. 8(135): p. 1-7. 19. Freeman, G., et al., Promoting continuity of care for people with severe mental illness whose needs span primary, secondary and social care: a multi-method investigation of relevant mechanisms and contexts. 2002, NCCSDO: London. 20. Ritchie, J. and J. Lewis, Qualitative Research Practice: A Guide for Social Science Students and Researchers. 2003, London: Sage. 21. Patel, V., et al., Mental health of young people: a global public-health challenge. The Lancet, 2007. 369: p. 1302-1313. 22. McGorry, P., The specialist youth mental health model: strengthening the weakest link in the public mental health system. Medical Journal of Australia (supplement), 2007. 187(7): p. s53-s56. 23. Cosgrave, E.M., et al., Met and unmet need in youth mental health. Journal of Mental Health, 2008. 17(6): p. 618-628. 24. Davis, M., J.L. Geller, and B. Hunt, Within-state availability of transition-to-adulthood services for youths with serious mental health conditions. Psychiatr Serv, 2006. 57(11): p. 1594-9. 25. Singh, S.P., et al., Mind the gap: the interface between child and adult mental health services. Psychiatric Bulletin, 2005. 29(8): p. 292-294. 26. Burns, T., et al., Experiences of continuity of care and health and social outcomes: the ECHO study. 2007, National Coordinating Centre for Service Delivery and Organisation: London. 27. National CAMHS Review, Children and young people in mind: the final report of the National CAMHS Review. 2008, Department for Children, Schools and Families and Department of Health. 28. Department for Education and Skills and Department of Health, Report on the implementation of standard 9 of the national service framework for children, young people and maternity services. 2006, Department of Health: London. 29. Maitra, B. and A. Jolley, Liaison between child and adult psychiatric services, in Family Matters: Interface Between Child and Adult Mental Health, P. Reder, M. McClure, and A. Jolley, Editors. 2000, Routledge: London. p. 285-302. 30. HASCAS, CAMHS to adult transition: a literature review for informed practice. n.d., Health and Social Care Advisory Service (HASCAS) Tools for Transition, Department of Health: London. 31. Social Exclusion Unit, Transitions: young adults with complex needs. 2005, Office of the Deputy Prime Minister: London.
URI:	http://wrap.warwick.ac.uk/id/eprint/3756