Mental health service transitions for young people

About this guide

The guide is based on research and practice knowledge from the following sources. The evidence base consists primarily of a practice enquiry and a research briefing.

Practice enquiry

A practice enquiry is a 'made to order' structured or semi-structured original enquiry into aspects of current practice in health and social care. This practice enquiry aimed:

• to identify and report on practice that is promising and/or innovative in relation to service transitions from CAMHS to AMHS and other adult services that support young people's mental health
• to map existing transitional pathways and issues in three geographic areas to explore the different experiences of young people with mental health problems who make (or do not make) the transition from CAMHS to AMHS and other adult services. 

There were two main strands of activity: 

• a national call for promising practice that supports service transitions, and the development of five promising practice case studies
• at a system level, mapping the transition processes in three different geographic areas with commissioners, managers and practitioners, followed by eight interviews with young people across the three areas to explore individual experiences and pathways of transition.

 The practice enquiry fieldwork took place in England. The call for practice and web searches for good practice covered the whole of the UK.

 SCIE's 2009 guidelines for practice enquiries list the limitations of this approach, stating that practice enquiries 'cannot':

• establish or quantify the prevalence of specific practices because a universal – and perhaps even a representative – sample of responses cannot be achieved
• provide evidence that is generalisable – it 'may' be highly suggestive of what is happening in the field, and 'may' identify a range of models, but it cannot reliably report how many people or organisations are following these models
• offer an independent assessment of practice, since most practice examples are based on self-reports
• provide objective evidence of 'good' or 'best' practice, since this would require a rigorous and comparative assessment of the quality of the practice and its outcomes.

In this practice enquiry, there are a relatively small number of interviews with young people, meaning the sample is not large. Also, the views of parents and carers are not included as they were not interviewed.

Research briefing

SCIE research briefings provide a concise summary of recent research into a particular topic and signpost routes to further information. They are designed to provide research evidence in an accessible format to a varied audience, including health and social care practitioners, students, managers and policy-makers. The briefings do not provide a definitive statement of all evidence on a particular issue.

This research briefing looked at recent research literature (since 2000) on the move from CAMHS to adult services for young people with psychological, emotional or behavioural problems. This briefing asked:

• 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?

The majority of the literature surveyed was UK-based, but some came from the USA and Australia. In the light of previous reviews of this area, literature since 2008 was prioritised where it covered the same issues or groups of young people as earlier literature.

SCIE research briefing methodology was followed throughout (inclusion criteria; material not comprehensively quality assured; evidence synthesised and key messages formulated by author). The information on which all briefings are based is drawn from relevant electronic databases, journals and texts, and where appropriate from alternative sources, such as inspection reports and annual reviews as identified by the authors. Scoping and searching was carried out in April 2010, with further searching between June and August 2010. The briefing was peer reviewed internally for methodology and 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 includes practitioners and young people.

Guidance from the advisory group

The advisory group suggested adding a section on access for seldom-heard and vulnerable groups of young people. This has been included, in some cases drawing on material additional to that in the research briefing.

Acknowledgements

SCIE would like to thank the following people who contributed to the knowledge base: Isabelle Brodie for the research briefing, and the Office for Public Management for the practice enquiry.  Also, Cathy Street, consultant, who contributed material, and the advisory group, who guided us throughout, particularly the young people in the group. Thank you all.