Transition from child to adult mental health services: a French retrospective survey

2016 ◽  
Vol 11 (5) ◽  
pp. 286-293 ◽  
Author(s):  
Aurélie Schandrin ◽  
Delphine Capdevielle ◽  
Jean-Philippe Boulenger ◽  
Monique Batlaj-Lovichi ◽  
Frédérick Russet ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Care Pathway ◽  
Small Sample ◽  
University Hospital ◽  
Retrospective Survey ◽  
Content Type ◽  
Adult Mental Health

Purpose 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. Design/methodology/approach 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. Findings 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. Research limitations/implications This is a retrospective study on a small sample but it reveals important data about transition in France. Practical implications Transition process should include collaborative working between CAMHS and AMHS, with cross-agency working and periods of parallel care. Social implications Transition-related discontinuity of care is a major socioeconomic and societal challenge for the EU. Originality/value Data related to the collaboration between CAMHS and AMHS services are scarce, especially regarding the transition in France.

Novel research on transition from child to adult mental health services in Europe: The MILESTONE project

2016 ◽  
Vol 33 (S1) ◽  
pp. S58-S59 ◽  
Author(s):  
H. Tuomainen ◽  
S.P. Singh ◽  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Providers ◽  
Care Pathway ◽  
Controlled Trial ◽  
Ethical Challenges ◽  
Adult Mental Health ◽  
Related Service ◽  
Competing Interest

IntroductionCurrent service configuration of distinct Child and Adolescent Mental Health (CAMHS) and Adult Mental Health Services (AMHS) is considered the weakest link where the care pathway should be most robust. Transition-related discontinuity of care is a major health, socioeconomic and societal challenge for the EU.ObjectivesThe overall objective of the MILESTONE project is to improve transition from CAMHS to AMHS in diverse healthcare settings in Europe.AimsTo improve the understanding of current transition-related service characteristics, and processes, outcomes and experiences of transition from CAMHS to AMHS using a bespoke suite of measures; to explore the ethical challenges of providing appropriate care to young people as they move to adulthood; to test a model of managed transition in a cluster randomized controlled trial (cRCT) for improving health, social outcomes and transition to adult roles; and to develop training modules for clinicians and policy guidelines.MethodsData will be collected via systematic literature reviews; bespoke surveys to CAMHS professionals, experts and other stakeholders; focus groups with service providers and users and members of youth and mental health advocacy groups; and a longitudinal cohort study with a nested cRCT in eight EU countries (Belgium, Croatia, France, Germany, Ireland, Italy, Netherlands, UK) involving over 1000 CAMHS service users, their parents/carers, and clinicians, with assessments at baseline, 9, 18 and 27 months.ResultsFirst results are expected in 2016 with further major findings following in 2019.ConclusionsThe MILESTONE project will provide unprecedented information on the nature and magnitude of problems at the CAMHS-AMHS interface, and potential solutions to overcome these.Disclosure of interestThe authors have not supplied their declaration of competing interest.

“Walking wounded or wounded healer?” Does personal experience of mental health problems help or hinder mental health practice? A review of the literature

2014 ◽  
Vol 18 (1) ◽  
pp. 35-44 ◽  
Author(s):  
Catherine Conchar ◽  
Julie Repper
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Peer Support ◽  
Personal Experience ◽  
Mental Health Problems ◽  
Health Problems ◽  
Review Of The Literature ◽  
Wounded Healer ◽  
Content Type

Purpose – A systematic review of the literature on “wounded healers” was undertaken to identify, define and interpret the term and its application within the mental health environment. The paper aims to discuss these issues. Design/methodology/approach – Eight key medical/social sciences databases were interrogated. In total, 835 papers were identified in the systematic database search and abstracts were obtained for each to determine whether they met the inclusion criteria. In total, 237 sources were retrieved for critical reading, to assess relevance and value to the review, and 125 documents were subsequently included. Through thematic analysis a number of themes and sub themes were identified Findings – The archetypal image of the wounded healer originates in ancient mythology and crosses many cultures. There are many interpretations and applications of the belief that having healed their own wounds a person is in a better position to heal others, however, the evidence to support this is not so robust. Of more direct relevance to contemporary practice are reports of supporting staff with mental health problems to make a contribution to mental health services, most recently through the employment of peer support workers. Originality/value – As peer support workers are increasingly being employed in mental health services, it is helpful to consider the many existing staff who bring personal experience of mental health problems. This paper explores the evidence that their lived experience makes a difference to the way that they work and considers their employment support needs.

Autistic spectrum disorder without intellectual impairment in adult mental health services – fostering new perspectives and enhancing existing services

2018 ◽  
pp. 1-7
Author(s):  
N. Crowley ◽  
H. O’Connell ◽  
M. Gervin
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Autistic Spectrum Disorder ◽  
Mental Health Problems ◽  
Health Problems ◽  
Spectrum Disorder ◽  
Intellectual Impairment ◽  
Autistic Spectrum ◽  
Adult Mental Health

Autistic spectrum disorder (ASD) is a neuro-developmental disability with multi-systemic impacts. Individuals with ASD without intellectual impairment (DSM-V) or Aspergers (DSM-IV) are often particularly vulnerable to mental health problems such as anxiety disorders including social phobia and generalised anxiety disorder, depressive disorders and psychosis. Adults with ASD without intellectual impairment suffer higher rates of physical and psychiatric morbidity, display a poorer ability to engage with treatment and have a lower chance of recovery compared with the general population. It is widely acknowledged that adults with suspected ASD without intellectual impairment and co-morbid mental health problems are often not best supported through adult mental health services and often require more tailored supports. This review seeks to (a) increase awareness in the area of undiagnosed cases of ASD without intellectual impairment in adult mental health settings and (b) highlights the importance of identifying this population more efficiently by referring to best practice guidelines. The value of future research to examine the benefit of having a team of specialist staff within adult mental health teams who have received ASD training and who are supported to work with the ‘core difficulties’ of ASD is discussed and a model for the same is proposed. It is proposed that a specialist team could form a ‘hub’ for the development of expertise in ASD, which when adequately resourced and funded could reach across an entire region, offering consultancy and diagnostic assessments and interventions.

“When other people try to understand”: exploring the experiences of people with intellectual disabilities, who also have mental health problems

2020 ◽  
Vol 14 (3) ◽  
pp. 91-101
Author(s):  
Sasha Martine Mattock ◽  
Kieron Beard ◽  
Amy Baddeley
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Focus Group ◽  
Health Services ◽  
Intellectual Disabilities ◽  
Mental Health Problems ◽  
Health Problems ◽  
Content Type ◽  
The People ◽  
People With Intellectual Disabilities

Purpose Recent guidelines from the National Institute of Health and Care Excellence highlight that service users (SUs) with intellectual disabilities and co-occurring mental health problems rarely get the opportunity to share their experiences of mental health services. Over the past 20 years, policy documents have stated that these individuals (SUs) must be included in decisions about their care. Research suggests that often this is not the case. Therefore, this paper aims to create a space for SUs to share their experiences of mental health services, and what they found helpful. Design/methodology/approach A focus group was held with five SUs, two psychologists and two researchers. The audio recording of the discussion was transcribed and analysed using thematic analysis. Findings Three main themes were identified, namely, “relationships with others”, “inclusion and communication” and “challenges”. This focus group highlighted that although some SUs felt supported, they reported having little control in their lives and wanted to be listened to. Research limitations/implications Including a SU in the planning and facilitation of the focus group would have made this research more inclusive. Practical implications The implications of this research suggest that by listening to and involving SUs and developing more person-centred services, recovery rates may increase as the services provided would be more targeted. Originality/value Very little research has previously been conducted to explore SUs’ experiences. This paper highlights the value of being heard and the knowledge that is often lost if the authors do not take the time to listen to the people for whom a service is designed.

Young service users from refugee backgrounds: their perspectives on barriers to accessing Australian mental health services

2017 ◽  
Vol 10 (1) ◽  
pp. 68-80 ◽  
Author(s):  
Madeleine Claire Valibhoy ◽  
Josef Szwarc ◽  
Ida Kaplan
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Health Professionals ◽  
Mental Health Problems ◽  
Health Problems ◽  
Explanatory Models ◽  
Service Users ◽  
Content Type

Purpose The purpose of this paper is to examine barriers to accessing mental health services, from the perspective of young people of refugee background who have been service users, and to suggest strategies to improve access to mental health services. Design/methodology/approach A qualitative study was conducted with 16 young people (aged 18-25), who had been refugees and who had attended mental health professionals in Australia. Interview transcripts were analysed thematically to examine participants’ perspectives on what hinders initial access to mental health services. Findings Stigma about mental health problems was particularly prominent. Many believed a high level of disturbance was the threshold for entering services, and for some there was no knowledge of such services’ existence. Options for assistance other than mental health services were often preferred, according to young people’s explanatory models. Apprehension was expressed that sessions would be uncomfortable, distressing or ineffective. The desire to be self-reliant functioned as a further barrier. Finally, structural obstacles and social exclusion deterred some young refugees from accessing services. Practical implications Implications include the need for service providers to be equipped to provide culturally sensitive, responsive services that ideally offer both practical and psychological assistance. Potential referrers, including health professionals and community leaders, could facilitate increased access if trained to recognise and address barriers. Finally, findings indicate potential content for awareness-raising initiatives for young refugees about mental health problems and services. Originality/value This paper is original in its sample, method, topic and findings; being drawn from the first known qualitative research exploring views of young mental health service users who have been refugees about barriers to accessing mental health services.

scholarly journals Challenges during the transition from child and adolescent mental health services to adult mental health services

2020 ◽  
Vol 44 (4) ◽  
pp. 163-168 ◽  
Author(s):  
Gaelle Hendrickx ◽  
Veronique De Roeck ◽  
Athanasios Maras ◽  
Gwen Dieleman ◽  
Suzanne Gerritsen ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Mental Health Problems ◽  
Mental Healthcare ◽  
Transition Process ◽  
Child And Adolescent ◽  
Smooth Transition ◽  
Adult Mental Health

The transition from child and adolescent to adult mental health services for young people with mental health problems is of international concern. Despite the high prevalence of mental disorders during adolescence and their tendency to continue during adulthood, the majority of young people do not experience continuity of care. The aim of this review paper is to unravel the complexity of transitional mental healthcare to clinicians, policy makers and mental health service managers, and to address challenges to a smooth transition process at all levels.

Clinicians’ perceptions of telephone-delivered mental health services

2019 ◽  
Vol 15 (2) ◽  
pp. 104-113
Author(s):  
Micaela Mercado ◽  
Virna Little
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Behavioral Health ◽  
Collaborative Care ◽  
Small Sample ◽  
Care Practice ◽  
Main Theme ◽  
Content Type

Purpose The adoption of telephone-delivered mental health services (TDMHS) for scaling collaborative care or addressing access to mental health services in routine primary care practice is gradual despite the needs of the population. Although there are multi-level factors associated with efficient implementation of collaborative care, there is limited understanding of clinicians’ perceptions, experiences and acceptability providing mental health treatment exclusively over the telephone. The purpose of this paper is to explore behavioral health clinicians’ delivery of mental health services over the telephone within primary care settings. Design/methodology/approach This qualitative study explored behavioral health professionals’ perceptions and experiences providing remote, TDMHS. Convenience sampling was used to recruit 11 clinicians in New York, California and Arizona who provided collaborative care services to patients exclusively over the telephone. Semi-structured interviews were conducted, and analyzed using qualitative content analysis methods. Findings Three main themes and associated subthemes emerged from the analyses. The first theme was participants’ perceptions of TDMHS prior to implementation relating to patient characteristics, patient engagement and comparison to in-person therapy. The second main theme identified was participants’ experiences implementing TDMHS with subthemes relating to benefits, quality of care, gaps in care and concerns implementing TDMHS. The final theme that emerged from the analysis was participants’ perceived acceptability of TDMHS by patients. Research limitations/implications The small sample size limits the generalizability of these findings. Practical implications Mental health services delivered over the telephone are perceived as feasible and acceptable by behavioral health clinicians. Originality/value This study contributes to gaps in research about behavioral health clinicians’ beliefs, uptake and acceptability toward mental health services delivered exclusively over the telephone.

scholarly journals Care pathway clustering: issues for older adult mental health services

2011 ◽  
Vol 15 (4) ◽  
pp. 6-9 ◽  
Author(s):  
Paul Whelan ◽  
Mo Zoha ◽  
Kristal Ramcharitar ◽  
Tresa Andrews
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Older Adult ◽  
Care Pathway ◽  
Adult Mental Health

Exploration of the dynamic barriers to adults with intellectual disabilities accessing mainstream mental health services

2015 ◽  
Vol 9 (6) ◽  
pp. 352-362 ◽  
Author(s):  
Paddy McNally ◽  
Kimberly McMurray
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Intellectual Disabilities ◽  
Learning Disability ◽  
Content Type ◽  
Adult Mental Health ◽  
Adult Mental Health Service

Purpose – The purpose of this paper is to investigate the experiences of psychologists in considering the barriers to people with intellectual disabilities being able to access mainstream mental health services. Design/methodology/approach – The information relating to participant experiences was gathered by conducting two focus groups: one with psychologists working in the adult mental health service and the second with psychologists working in the learning disability service. A thematic analysis was used to determine the main themes from each of the focus groups. Findings – The overarching themes for the psychologists in the adult mental health service related to: service restrictions; confidence in their ability/skills; and resistance to change. The overarching themes for the psychologists in the learning disability service reflected: future thinking; protection; pessimism; and clarification around mental health and learning disability. Originality/value – The discussion includes consideration of the dynamic positions of the two services and recommendations for an integrated system of working.

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