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Transition from CAMHS to adult mental health services (TRACK): a study of service organisation, policies, process and user and carer perspectives
- Authors:
- SINGH Swaran P., et al
- Publisher:
- National Institute for Health Research. Service Delivery and Organisation Programme
- Publication year:
- 2010
- Pagination:
- 251p., bibliog.
- Place of publication:
- Southampton
There has been long standing concern about young people with mental health problems transferring from child and adolescent mental health services (CAMHS) to adult mental health services. The TRACK study aimed to identify factors that facilitate or impede effective transition of patients from CAMHS to adult services, and make recommendations about the configuration and delivery of services that will promote good continuity of care. The study comprised 4 stages. Stage 1 involved mapping CAMHS services and auditing transition policies in 6 trusts in Greater London and West Midlands. Stage 2 comprised tracking the pathways and outcomes of all users who crossed transition boundary in a given year. Stage 3 involved a diagnostic analysis across health services and voluntary sector using semi-structured interviews. Finally, stage 4 comprised qualitative interviews with a sub-sample of service-users, carers and care co-ordinators. This report provides the findings and conclusions from each stage of the study. Overall, the findings show that, for the vast majority of service users, transition from CAMHS to adult services is poorly planned, poorly executed and poorly experienced. Many young people with ongoing mental health need fall through the gap between CAMHS and adult services, especially those with neurodevelopmental, emotional or personality disorders, with neither CAMHS nor adult services appearing to accept responsibility. Even among those who cross the gap, very few experience optimal transition. The report concludes by discussing 2 approaches to improving transition from CAMHS to adult services: improving the interface between CAMHS and adult services as they currently exist; or developing a completely new and innovative service model of integrated youth mental health services.
Transition from CAMHS to adult mental health services (TRACK): a study of service organisation, policies, process and user and carer perspectives: executive summary
- Authors:
- SINGH Swaran P., et al
- Publisher:
- National Institute for Health Research. Service Delivery and Organisation Programme
- Publication year:
- 2010
- Pagination:
- 5p.
- Place of publication:
- Southampton
There has been long standing concern about young people with mental health problems transferring from child and adolescent mental health services (CAMHS) to adult mental health services. The TRACK study aimed to identify factors that facilitate or impede effective transition of patients from CAMHS to adult services, and make recommendations about the configuration and delivery of services that will promote good continuity of care. The study comprised 4 stages. Stage 1 involved mapping CAMHS services and auditing transition policies in 6 trusts in Greater London and West Midlands. Stage 2 comprised tracking the pathways and outcomes of all users who crossed transition boundary in a given year. Stage 3 involved a diagnostic analysis across health services and voluntary sector using semi-structured interviews. Finally, stage 4 comprised qualitative interviews with a sub-sample of service-users, carers and care co-ordinators. This executive summary reports on the key findings from each stage of the study. Overall, the findings show that, for the vast majority of service users, transition from CAMHS to adult services is poorly planned, poorly executed and poorly experienced. Many young people with ongoing mental health need fall through the gap between CAMHS and adult services, especially those with neurodevelopmental, emotional or personality disorders, with neither CAMHS nor adult services appearing to accept responsibility. Even among those who cross the gap, very few experience optimal transition.
Process, outcome and experience of transition from child to adult mental healthcare: multiperspective study
- Authors:
- SINGH Swaran P., et al
- Journal article citation:
- British Journal of Psychiatry, 197(4), October 2010, pp.305-312.
- Publisher:
- Cambridge University Press
This article reports part of the UK TRACK study looking at process, outcomes and user and carer experience when adolescents with mental health problems transition from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS). A cohort of service users crossing the CAMHS/AMHS boundary over 1 year was identified from across six mental health trusts in England. Their journey was tracked and a subsample of users (11), their carers (6) and clinicians (9) was interviewed. Of 154 individuals who crossed the transition boundary, 90 were actual referrals (i.e. they made a transition to AMHS), and 64 were potential referrals (were not referred to AMHS or not accepted by AMHS). Those with a history of severe mental illness, being on medication or having been admitted were more likely to make a transition than those with neurodevelopmental disorders, emotional/neurotic disorders and emerging personality disorder. Optimal transition, defined as adequate transition planning, good information transfer across teams, joint working between teams and continuity of care following transition, was experienced by less than 5% of those transitioning. Following transition, most service users stayed engaged with AMHS and reported improvement in their mental health. The authors conclude that for the majority of service users, transition from CAMHS to AMHS is poorly planned, poorly executed and poorly experienced. The transition process accentuated pre-existing barriers between CAMHS and AMHS.