Interventions to improve transition of care for adolescents from paediatric services to adult services

Campbell, Fiona; O'Neill, P.; While, Alison; McDonagh, Janet E.

doi:10.1002/14651858.cd009794

Cited by 10 publications

(9 citation statements)

References 27 publications

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“…A particularly vulnerable group is represented by looked‐after young people in the public care system, who are less likely to have family support but have significant mental health and social problems, including higher risk of self‐harm and suicide, poorer educational achievement, and greater risk of unemployment, homelessness and incarceration . The labyrinthine service structures and interface means that the complex mental health needs of care‐leavers remain unmet as they fall through the care gap or disengage from services , increasing their use of crisis care and ultimately leading to poor outcomes.…”

Section: Transition In Mental Healthmentioning

confidence: 99%

Transition from child to adult mental health services: needs, barriers, experiences and new models of care

2015

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Section: Transition In Mental Healthmentioning

confidence: 99%

Transition from child to adult mental health services: needs, barriers, experiences and new models of care

2015

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“…Despite recognition that LAYP are best served by dedicated mental health services (Golding, ; Tarren‐Sweeney, ), few such services exist. LAYP and care‐leavers are likely to be more at risk as their complex needs remain unmet; they fall through the care gap (Campbell, O'Neill, While & McDonagh, ), disengaging from services despite continuing need (Brodie et al., ), increasing their use of crisis care (Meltzer et al., ) and ultimately experiencing poorer outcomes. There is little evidence on what care‐leavers with mental illness believe is important in the transition process, the barriers to engagement with mental health services and how these may be overcome.…”

Section: Introductionmentioning

confidence: 99%

Transitioning care‐leavers with mental health needs: ‘they set you up to fail!’

Butterworth

Singh

Birchwood

et al. 2016

Child Adoles Ment Health

113

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Background Children in the UK care system often face multiple disadvantages in terms of health, education and future employment. This is especially true of mental health where they present with greater mental health needs than other children. Although transition from care – the process of leaving the local authority as a child‐in‐care to independence – is a key juncture for young people, it is often experienced negatively with inconsistency in care and exacerbation of existing mental illness. Those receiving support from child and adolescent mental health services (CAMHS), often experience an additional, concurrent transfer to adult services (AMHS), which are guided by different service models which can create a care gap between services. Method This qualitative study explored care‐leavers’ experiences of mental illness, and transition in social care and mental health services. Twelve care‐leavers with mental health needs were interviewed and data analysed using framework analysis. Results Sixteen individual themes were grouped into four superordinate themes: overarching attitudes towards the care journey, experience of social care, experience of mental health services and recommendations. Conclusions Existing social care and mental health teams can improve the care of care‐leavers navigating multiple personal, practical and service transitions. Recommendations include effective Pathway Planning, multiagency coordination, and stating who is responsible for mental health care and its coordination. Participants asked that youth mental health services span the social care transition; and provide continuity of mental health provision when care‐leavers are at risk of feeling abandoned and isolated, suffering deteriorating mental health and struggling to establish new relationships with professionals. Young people say that the key to successful transition and achieving independence is maintaining trust and support from services.

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“…According to Blum et al , 9 transition is the “purposeful, planned movement of adolescents and young adults with chronic medical conditions from child-centered to adult- oriented health care systems.” A successful transition plan recognises transition as a multifaceted process that engages multiple care providers and accommodates a patient's condition, chronological age and developmental stage. 2 4 10 11 …”

Section: Introductionmentioning

confidence: 99%

Health system strategies supporting transition to adult care

et al. 2015

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BackgroundThe transition from paediatric to adult care is associated with poor clinical outcomes, increased costs and low patient and family satisfaction. However, little is known about health system strategies to streamline and safeguard care for youth transitioning to adult services. Moreover, the needs of children and youth are often excluded from broader health system reform discussions, leaving this population especially vulnerable to system ‘disintegration’.Objectives(1) To explore the international policy profile of paediatric-to-adult care transitions, and (2) to document policy objectives, initiatives and outcomes for jurisdictions publicly committed to addressing transition issues.MethodsAn international policy scoping review of all publicly available government documents detailing transition-related strategies was completed using a web-based search. Our analysis included a comparable cohort of nine wealthy Organisation for Economic Co-operation and Development (OECD) jurisdictions with Beveridge-style healthcare systems (deemed those most likely to benefit from system-level transition strategies).ResultsFew jurisdictions address transition of care issues in either health or broader social policy documents. While many jurisdictions refer to standardised practice guidelines, a few report the intention to use powerful policy levers (including physician remuneration and non-physician investments) to facilitate the uptake of best practice. Most jurisdictions do not address the policy infrastructure required to support successful transitions, and rigorous evaluations of transition strategies are rare.ConclusionsDespite the well-documented risks and costs associated with a poor transition from paediatric to adult care, little policy attention has been paid to this issue. We recommend that healthcare providers engage health system planners in the design and evaluation of system-level, policy-sensitive transition strategies.

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Interventions to improve transition of care for adolescents from paediatric services to adult services

Cited by 10 publications

References 27 publications

Transition from child to adult mental health services: needs, barriers, experiences and new models of care

Transition from child to adult mental health services: needs, barriers, experiences and new models of care

Transitioning care‐leavers with mental health needs: ‘they set you up to fail!’

Health system strategies supporting transition to adult care

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