Transition from child and adolescent to adult mental health services: an evaluation

Abstract

Evidence has highlighted dissatisfaction among patients with the process of transitioning from child and adolescent mental health services (CAMHS) to adult mental health services. This study aimed to evaluate compliance with and the impact of recommendations made at a mental health trust to improve the transition process after an audit carried out in 2015. A nine-item audit tool was developed based on National Institute for Health and Care Excellence guidelines for transition from CAMHS to adult mental health services. Patient records were obtained from the trust's health informatics service and analysed for the calendar year of 2015, looking at compliance with the guidance. The results were used to implement recommendations to improve the transition process, then the audit was repeated for the calendar year of 2017. Data were analysed using descriptive statistics to compare the two periods and identify areas of improvement, or lack thereof. A total of 52 and 75 case records were audited in the 2015 and 2017 evaluations respectively. Some improvements were seen in some areas over the 2-year period, such as the introduction of a named transition worker and more joint working between child and adolescent and adult mental health services. However, several domains of practice still had low levels of compliance with recommendations in the 2017 audit, particularly items relating to information sharing and communication with patients and their caregivers. Further work is needed to improve compliance with recommendations for transitional care in mental health services, particularly in terms of communication and involvement of the patient during this process. More research is needed into the barriers to effective transition and any strategies implemented to improve this process should be evaluated using robust methods. Successful strategies will likely require investment in staff recruitment and retention.