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Giulia Signorini, Nikolina Davidovic, Gwen Dieleman, Tomislav Franic, Jason Madan, Athanasios Maras, Fiona Mc Nicholas, Lesley O'Hara, Moli Paul, Diane Purper-Ouakil, Paramala Santosh, Ulrike Schulze, Swaran Preet Singh, Cathy Street, Sabine Tremmery, Helena Tuomainen, Frank Verhulst, Jane Warwick, Dieter Wolke and Giovanni de Girolamo
Young people transitioning from child to adult mental health services are frequently also known to social services, but the role of such services in this study and their…
Young people transitioning from child to adult mental health services are frequently also known to social services, but the role of such services in this study and their interplay with mental healthcare system lacks evidence in the European panorama. This study aims to gather information on the characteristics and the involvement of social services supporting young people approaching transition.
A survey of 16 European Union countries was conducted. Country respondents, representing social services’ point of view, completed an ad hoc questionnaire. Information sought included details on social service availability and the characteristics of their interplay with mental health services.
Service availability ranges from a low of 3/100,000 social workers working with young people of transition age in Spain to a high 500/100,000 social workers in Poland, with heterogeneous involvement in youth health care. Community-based residential facilities and services for youth under custodial measures were the most commonly type of social service involved. In 80% of the surveyed countries, youth protection from abuse/neglect is overall regulated by national protocols or written agreements between mental health and social services, with the exception of Czech Republic and Greece, where poor or no protocols apply. Lack of connection between child and adult mental health services has been identified as the major obstacles to transition (93.8%), together with insufficient involvement of stakeholders throughout the process.
Marked heterogeneity across countries may suggest weaknesses in youth mental health policy-making at the European level. Greater inclusion of relevant stakeholders is needed to inform the development and implementation of person-centered health-care models. Disconnection between child and adult mental health services is widely recognized in the social services arena as the major barrier faced by young service users in transition; this “outside” perspective provides further support for an urgent re-configuration of services and the need to address unaligned working practices and service cultures.
This is the first survey gathering information on social service provision at the time of mental health services transition at a European level; its findings may help to inform services to offer a better coordinated social health care for young people with mental health disorders.
Aurélie Schandrin, Delphine Capdevielle, Jean-Philippe Boulenger, Monique Batlaj-Lovichi, Frédérick Russet and Diane Purper-Ouakil
Adolescents and young adults’ mental health problems are an important health issue. However, the current organisation of the care pathway is not robust enough and…
Adolescents and young adults’ mental health problems are an important health issue. However, the current organisation of the care pathway is not robust enough and transition between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) has been identified as a period of risk. The paper aims to discuss these issues.
A retrospective survey was conducted in Montpellier University Hospital concerning transitions organised between CAMHS and AMHS between 2008 and 2009. The aim was to assess if transitions met four criteria identified in literature as warranting an optimal transition.
In total, 31 transitions were included. Transition was accepted by AMHS in 90 per cent of cases but its organisation was rarely optimal. Relational continuity and transition planning were absent in 80 per cent of cases. The age boundary of 16 often justified the triggering of the transition regardless of patient’s needs. Discontinuity was observed in 48 per cent of transition cases, with an average gap of three months without care. Psychiatrists reported difficulties in working together. Finally, at the moment of the survey (one to three years later), 55 per cent of patients were lost to follow-up.
This is a retrospective study on a small sample but it reveals important data about transition in France.
Transition process should include collaborative working between CAMHS and AMHS, with cross-agency working and periods of parallel care.
Transition-related discontinuity of care is a major socioeconomic and societal challenge for the EU.
Data related to the collaboration between CAMHS and AMHS services are scarce, especially regarding the transition in France.