SCIE Research briefing 37: Mental health service transitions for young people
By Isabelle Brodie, Rebecca Goldman and Janet Clapton
Published: May 2011
This briefing looks at recent research literature (since 2000) on the move from child and adolescent mental health services (CAMHS) to adults’ services for young people with psychological, emotional or behavioural problems, referred to as ‘mental health service transitions’. Young people may move to adult mental health services (AMHS) or need alternative support in young adulthood. Despite evidence of some promising and innovative practice, this is an issue of longstanding concern to young people, their families, practitioners and policy-makers, both in the UK and abroad.
This briefing asks:
- What do professionals, young people, parents, carers and families think about mental health service transitions and what has their experience been?
- What evidence is there for good practice and service models in supporting successful service transitions?
- Moving from child and adolescent mental health services to adult services is difficult for many young people, their parents and carers.
- Recurrent problems include limited participation of young people, high eligibility thresholds for entry into adult mental health services and inconsistent support during transition. This leads to some young people ceasing to use services until a crisis occurs.
- Service transition is a process, and needs to take account of the wider context of young people’s lives, including education, employment, housing and overall health needs.
- Young people, their families and carers want their views to be taken seriously and to participate actively in the process of transition. They value good information, consistent support from a key worker and flexible, non-stigmatising community-based services appropriate for their age group.
- Good practice also involves collaborative flexible working between agencies, clear protocols and transparent planning meetings.
- There are limited adults’ services for specific groups of young people, including those with attention-deficit hyperactivity disorder and autism spectrum disorders.
- Many practice developments and service models for improving transitions are at an early stage of development, and there are few robust effectiveness studies currently available. No research studies were found on costs or cost-effectiveness.
- Implications for service improvement are set out towards the end of this briefing. These include young people needing transitional support from CAMHS and voluntary sector agencies to help them adapt to the different culture of adults’ services.
About the development of this product
This work was part of the Young People's Mental Health Transitions Project, funded by the DH, and joint between SCIE, the National Mental Health Development Unit and National CAMHS Support Service. Other products include a practice enquiry, a guide for frontline services, legal guides for practitioners, young people and parent/ carers, a guide for commissioners, e-learning and a self-assessment tool.
Scoping and searching
Scoping and searching was carried out in April 2010, with further searching between June and August 2010.
Peer review and testing
The briefing was peer reviewed internally for methodology. It was peer reviewed externally by two topic experts, Dr Cathy Street and Dr Moli Paul. Comments were also received from the SCIE mental health service transitions advisory group which included practitioners and young people.