Mental health service transitions for young people
Accessible and easy to use mental health services: Access for seldom-heard and vulnerable groups
- Refer young people to age-appropriate, accessible services where they exist; tell commissioners and providers where they don't exist.
- Do not assume that young people in CAMHS need transfer to AMHS. For example, some young people may not meet the criteria for severe and enduring mental illness and thus may not be eligible for AMHS.
- Offer young people additional and alternative support to AMHS including support from non-health settings, voluntary sector services, primary health care (including GPs) and other universal services.
Socially excluded young people who need mental health services may be 'hidden' and find it difficult to get support. Some may have a disrupted history of accessing services and encounter stigma, racism and language difficulties. These young people may need more intensive support to avoid being overlooked.
Young people who may encounter particular difficulties accessing services, or being supported when they are in transition, include:
- those who are not in education, employment or training (NEET)
- looked-after young people or care-leavers;
- those who are refugees or asylum-seekers
- those who are from traveller communities
- those who live in isolated rural areas.
Poverty, a high risk factor for children and young people's mental health, is particularly prevalent in rural areas and this, combined with limited public transport, can restrict young people's access to mental health provision and support. For some groups, their problems accessing services are recognised and specialist teams provide support - for example, by offering outreach and satellite services in outlying areas and developing telephone and internet-based sources of information and advice.
Young people from black and minority ethnic (BME) communities are also recognised as a group whose access to and use of mental health services can be poor. People from BME communities are more likely to experience problems with access and reduced satisfaction with services, cultural and language barriers, lower GP involvement in care, inadequate community-based crisis care, higher rates of admission to hospital and longer lengths of stay. (13, 14)
Other research has revealed that young people from minority ethnic groups disproportionately experience many of the known risk factors for developing mental health problems including being looked-after or homeless. Research emphasises the importance of services being culturally sensitive and appropriate, being community-based, easy to access, non-stigmatising and with good links to local voluntary sector provision. (15, 16)
Young people who are in hospital, whether an adolescent CAMHS unit, or an adult ward, are also at risk because they may be placed some considerable distance from their local area and have infrequent contact with their CAMHS co-ordinator. A particular problem can also arise if a young person passes their eighteenth birthday (i.e. the transition boundary from CAMHS). The lack of involvement of young people themselves in their care and discharge planning when they are inpatients has been documented as a significant problem in a number of reports.
'I remember coming here [adult secure ward] and there were lots of people kicking off … it was a big shock coming to the secure unit'Angela