To investigate the organisational factors that impede or facilitate transition of young people from child and adolescent (CAMHS) to adult mental health services (AMHS).
Methods
Thirty-four semi-structured interviews were conducted with health and social care professionals working in child and adult services in four English NHS Mental Health Trusts and voluntary organisations. Data were analysed thematically using a structured framework.
Results
Findings revealed a lack of clarity on service availability and the operation of different eligibility criteria between child and adult mental health services, with variable service provision for young people with attention deficit hyperactivity disorder, autism spectrum disorders and learning disabilities. High workloads and staff shortages were perceived to influence service thresholds and eligibility criteria.
Conclusions
A mutual lack of understanding of services and structures together with restrictive eligibility criteria exacerbated by perceived lack of resources can impact negatively on the transition between CAMHS and AMHS, disrupting continuity of care for young people.
Harpaz RotemILeslieDRosenheckRA. Treatment retention among children entering a new episode of mental health care. Psychiatr Serv2004; 55: 1022–1028.
2.
American Academy of Paediatrics, American Academy of Family Physicians, American College of Physicians-American Society of Internal Medicine. A consensus statement on health care transitions for young adults with special health care needs. Paediatrics2002; 110: 1304–1306.
3.
McGorryPD. The specialist youth mental health model: strengthening the weakest link in the public mental health system. Med J Aust2007; 187(suppl 7): S53–S56.
4.
VloetMDavidsonSCapelliM. We suffer from being lost: reformulating policies to reclaim youth in mental health transitions. Healthcare Q2011; 14: 32–38.
5.
CrawleyRWolfeILockK. Improving the transition between paediatric and child healthcare: a systematic review. Arch Dis Child2011; 96: 548–553.
6.
DavisMGellerJLHuntB. Within-state availability of transition to adult services for youths with serious mental health conditions. Psychiatr Serv2006; 57: 1594–1599.
7.
Audit Commission. Children in mind, London: Audit Commission, 1999.
8.
National CAMHS Review. Children and young people in mind: the final report of the National CAMHS Review. Department for Children, Schools and Families and Department of Health, 2008.
9.
TreasureJSchmidtUHugoP. Mind the gap: transition and interface problems for patients with eating disorders. Br J Psychiatry2005; 167: 398–400.
10.
SinghSPEvansNSirelingL. Mind the gap: the interface between child and adult mental health services. Psychiatr Bull2005; 29: 292–294.
11.
SinghSP. Transitions of care from child to adult mental health services: the great divide. Curr Opin Psychiat2009; 22: 386–390.
12.
DavisMGreenMHoffmanCThe service system obstacle course for transition-age youth and young adults. In: ClarkHBUnruhD (eds). Transition of youth and young adults with emotional and behavioural difficulties: an evidence based handbook, Baltimore: Paul H Brooks & Co Publishers, 2009.
13.
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, London: Department of Health, 2008.
14.
NuttDJFoneKAshersonP. Evidence-based guidelines for management of attention-deficit/hyperactivity disorder in adolescents in transition to adult services and in adults: recommendations from the British Association for Psychopharmacology. J Psychopharmacol2006; 21: 10–41.
15.
Department of Health. Models of multi-agency services for transition for disabled young people and those with complex health needs: impact and costs, London: Department of Health Policy Research Programme, Social Policy Research Unit, 2010.
16.
Department of Health. National service framework for children, young people and maternity services, London: Department of Health, 2004.
17.
Social Exclusion Unit. Transitions: young adults with complex needs, London: Office of the Deputy Prime Minister, 2005.
18.
Singh SP, Paul M, Islam Z, et al. Transition from CAMHS to adult mental health services: a study of service organisation, policies, process, user and carer perspectives. NETSCC. SDO Project Reference 08/1613/117, 2009.
19.
SinghSPPaulMFordT. 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 Serv Res2008; 8(135): DOI: 10.1186/1472-6963-8-135.
20.
SinghSPPaulMFordT. Process, outcome and experience of transition from child to adult mental healthcare: a multi-perspective study. Br J Psychiatry2010; 197: 305–312.
21.
HovishKWeaverTIslamZ. Transition experiences of mental health service users, parents and professionals in the United Kingdom: a qualitative study. Psychiatr Rehabil J2012; 35: 251–257.
22.
PaulMFordTKramerT. TRACK: transfers and transitions between child and adolescent and adult mental health services. Br J Psychiatry2013; 202: s36–s40.
23.
McLarenSBellingRPaulM. ‘Talking a different language’: an exploration of the influence of organisational cultures and working practices on transition from child to adult mental health services. BMC Health Serv Res2013; 13: 254–254.
24.
Freeman G, Weaver T, Low J, 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. Report for the NCCSDO. London: NCCSDO, 2002.
25.
RitchieJSpencerLQualitative data analysis for applied policy research. In: BrymanABurgessR (eds). Analysing qualitative data, London: Routledge, 1994.
26.
Burns T, Catty J, Clement S, et al. Experiences of continuity of care and health and social care outcomes: the ECHO Study. Report for the NCCSDO, London, 2007.
