Mental health service transitions for young people
Practice example: ADHD Sheffield
The service aims to tackles the fears and anxieties that young people may have about AMHS and to reduce the frequency of unattended appointments by young people with ADHD once they have moved to adult services
An ADHD transition clinic and a transition patient group ‘Living with ADHD’ have been piloted, working with 16-25 year young people with an established diagnosis of ADHD made in childhood, who are thought to need to transition into AMHS for continuation of management of ADHD symptoms.
The clinic involves CAMHS and Adult Mental Health Services (AMHS) working together. The clinic has been running once a month, for six months and has seen 17 patients. Each young person attends a single clinic meeting which can involve a number of staff, including CAMHS consultants, nurses, therapists and AMHS psychiatrists. Parents/carers also usually attend.
The meeting is used to:
- review the patient's needs, medication and plan transition
- introduce patients and carers to members of adult services
- provide information (including a leaflet) about adult ADHD services
- invite young people to join a Transition group Living with ADHD.
Further appointments are arranged in accordance with clinical need (a minimum of every six months if medication is being prescribed under the Shared Care Protocol).
The transition group ‘Living with ADHD’ is made up of clients from the transition clinic and other young patients with ADHD under adult services who might benefit from being offered work around psychosocial issues in ADHD. These referrals were mainly from current clients with ADHD on the caseload of clinicans within the other AMHS in Sheffield. All are 16- 25 years of age. The sessions are co-run by an occupational therapist and a social worker from the adult CMHT.
Recognising that CAMHS can often be a more parent/carer-orientated service, each session of the transition group focuses on specific subject areas of interest to young people, including: medication, anger management, CBT techniques, vocation and education and the psycho education about ADHD including positive aspects. They also included a session with an older user with ADHD. The sessions provide the young people with an opportunity to ask questions, think about ways of developing useful strategies to cope with ADHD and ultimately learn more about their condition and treatment.
A number of methods are in place to measure outcomes. These will be implemented in the coming months as this new practice develops. In the meantime, staff are collecting feedback from young people and their parents/carers about their experiences of the service. This has generally been positive, although a small proportion of young people offered the transition group were not comfortable with a group environment.
Project costs are primarily in terms of staff time. The clinic requires one AMHS psychiatrist and one CAMHS psychiatrist to attend a session per month lasting three hours. This is an organisational change rather than a new resource. The group currently utilises one occupational therapist and one social worker to run the group a week, for 12 weeks. These sessions last two hours. This resource is currently supported by the AMHS CMHT budget. Other costs are in administrative support to set the programme up such as booking a venue and contacting patients. This is currently split between CAMHS and AMHS teams.