Managing Transition with Support: Experiences of Transition from Child and Adolescent Psychiatry to General Adult Psychiatry Narrated by Young Adults and Relatives

Abstract

Young adults with mental illness who need continuing care when they turn 18 are referred from child and adolescent psychiatry to general adult psychiatry. During this process, young adults are undergoing multiple transitions as they come of age while they transfer to another unit in healthcare. The aim of this study was to explore expectations and experiences of transition from child and adolescent psychiatry to general adult psychiatry as narrated by young adults and relatives. Individual interviews were conducted with three young adults and six relatives and analysed according to grounded theory. The analysis resulted in a core category: managing transition with support, and three categories: being of age but not mature, walking out of security and into uncertainty, and feeling omitted and handling concerns. The young adults' and relatives' main concerns were that they might be left out and feel uncertainty about the new situation during the transition process. To facilitate the transition process, individual care planning is needed. It is essential that young adults and relatives are participating in the process to be prepared for the changes and achieve a successful transition. Knowledge about the simultaneous processes seems to be an important issue for facilitating transition.

Review: Transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS): a meta‐synthesis of parental and professional perspectives

“…Transition guidance/protocols should be updated (van der Kamp, 2018) with clinician involvement, to help them to feel less marginalised (Kaehne, 2011) and aid implementation. The provision of information to service users and carers should be included in protocols, as parents perceive information as lacking (Lindgren, Soderberg, & Sk€ ar, 2014).…”

Swedish Young Adults’ Experiences of Psychiatric Care during Transition to Adulthood

“…The process can comprise a period of confusion and distress in-between fairly stable states (Chick & Meleis, 1986). Therefore, it is important to take into account young adults' experiences of care at the period of transition to adulthood and transfer from CAP to GenP (Lindgren et al, 2014). The concept of transition is consistent with a holistic view of health and promotes thinking that a person undergoes simultaneous transitions (Meleis et al, 2000).…”

“…As only one participant responded to the information letter, a decision was made to remove the inclusion criteria about referral from CAP to GenP and to create an advertisement in local newspapers and at patient associations inviting participation. This resulted in eight more participants and two additional participants were recruited from an earlier study (Lindgren et al, 2014). According to the difficulties in the recruitment process, two of the young adults were allowed to participate, even though they had reached the age of 26.…”

“…During the transition from CAP to GenP, there is a risk for disruption in continuity of care (Singh, 2009;Singh, Evans, Sireling, & Stuart, 2005); thus, it is important that professionals support the young adults and their relatives during transfer to avoid a gap in care (Lindgren, Söderberg, & Skär, 2014). By providing information and a plan for the transfer with cooperation between CAP and GenP, the transition can be facilitated and the young adults can be prepared for the changes.…”

Young patients’ views about provided psychiatric care

“…Patients highlight the importance of the therapeutic relationship in providing a safe and therapeutic milieu (14)(15)(16). Even if mental disorders usually have their onset in childhood or adolescence (17), there are only a few studies that examine the view of young adult patients (18,19). According to Swedish statistics, 4.3% of young adults between 18-24 years old seek psychiatric care each year (20).…”