scholarly journals Transition from child and adolescent mental health services to adult mental health services: children in care and adopted children

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S168-S169
Author(s):  
Paula Adamopoulos ◽  
Rani Samuel
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Child And Adolescent ◽  
Health Problems ◽  
Adopted Children ◽  
Adult Mental Health ◽  
Therapeutic Engagement ◽  
Children In Care

AimsMental health transition-related disengagement is a major public health problem. This study aims to review children in care (CIC) and adopted children's transitions from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS). This study aims to illustrate the often overlooked complexities that are associated with this population's transitions.It is hypothesised that this population is at an increased risk for disengagement post-transition. Such is hypothesised as a result of the population's increased prevalence of complex mental health problems, neuro-developmental needs and developmental trauma. This population would benefit from a transition (optimal), as opposed to a transfer of care (suboptimal).MethodThis retrospective case study included young people from Lewisham CAMHS's team for looked after and adopted children. Optimal transition was evaluated using four criteria: continuity of care, parallel care, a transition planning meeting and information transfer.ResultA total of 34 cases (male = 14, female = 20) were included, 88% of which were CIC (12% were adopted children). 85% of the cases included reports of at least one form of abuse and/or neglect. 59% of the cases were categorised as having more than one diagnostic group of mental health problems.30% (n = 11) of the cases were discharged and were not recorded to have re-engaged with Lewisham AMHS. 12% of the cases had an outcome as 'unknown' due to miscellaneous reasons.Only 18% (n = 6) of the cases had an ‘optimal’ transition. 18% (n = 6) had a suboptimal transfer and of those cases, 66% (n = 4) did not engage with AMHS beyond three months post-transfer. 21% (n = 7) were re-referred to Lewisham AMHS after being discharged from CAMHS. None of the re-referred cases engaged with AMHS post-referral.ConclusionIn conclusion, these findings demonstrate that this population is highly complex and can often experience suboptimal transitions from CAMHS to AMHS. Anything less than an 'optimal' transition yields a low ratel of therapeutic engagement. Recommendations for clinical practice includes an extended period of ‘overlap time’ between CAMHS to AMHS for CIC and adopted children. This overlap period will enable mental health practitioners to provide more informed and consistent support that incorporates the needs of CIC and adopted children. Such a provision will enhance therapeutic engagement and subsequently, promote better outcomes for CIC and adopted children. These findings have important resource implications for both CAMHS and AMHS teams.

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.

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.

scholarly journals Adult mental health services and the collaboration with child protection services

2016 ◽  
Vol 5 (5) ◽  
pp. 72 ◽  
Author(s):  
Camilla Lauritzen ◽  
Charlotte Reedtz
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Child Protection ◽  
Mental Health Problems ◽  
Health Problems ◽  
Child Protection Services ◽  
Adult Mental Health ◽  
Service Collaboration

Parental mental illness may increase the likelihood of neglect and abuse, and is also a potent risk factor in terms of offspring developing mental health problems themselves. Collaboration between the adult mental health services (AMHS) and the child protection services (CPS) has the potential of reducing risk for the children, by using family supporting interventions and making help available at an earlier stage. The aim of this study was to explore the collaboration between the CPS and the AMHS in terms of routines, attitudes and knowledge. Data was gathered using electronic survey questionnaires. Several barriers to inter-service collaboration were identified in this study. Even though adult mental health professionals were positive towards the CPS, they were reluctant to refer cases of concern. They also lacked knowledge about the CPS. Conclusion: The results indicate that there is an unresolved potential for inter-service collaboration involving the children of patients with mental health problems.

scholarly journals Do Parental Education-Related Inequality Matter in Child and Adolescent Utilization of Mental Health Services: Results From a Norwegian Register Linkage Study

2021 ◽  
Vol 14 ◽  
pp. 117863292110553
Author(s):  
Tormod Bøe ◽  
Mari Hysing ◽  
Kristin G Askeland ◽  
Jens Christoffer Skogen ◽  
Ove Heradstveit
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Parental Education ◽  
Mental Health Problems ◽  
Child And Adolescent ◽  
Health Problems ◽  
Education Levels ◽  
Specialized Mental Health

Equitable access to health care point to equal access to care for those with equal needs, but pro-rich and pro-educated inequities have been documented in specialized mental health care utilization. This study aimed to investigate equity in Norwegian adolescents’ use of child and adolescent mental health services (CAMHS) with regards to parental education levels, using a survey of 10 257 Norwegian 16- to 19-year-olds subsequently linked to CAMHS data from the Norwegian Patient Registry (n = 970 had been in contact with CAMHS). Analyses using concentration indices ( C) suggested adolescents with parents with lower education levels had more mental health problems (ie, larger need; C = −0.032, P < .001) and were more in contact with CAMHS ( C = −0.025, P < .001). Regression analysis suggested that CAMHS contact, and number of unique admissions was largely distributed according to need, but participants whose parents had basic education levels were in contact with CAMHS for slightly longer than predicted from their self-reported mental health problems, age, and sex. Results from this study suggested that contact with CAMHS was largely equitable and mostly influenced by need. There was little evidence of parental education-related inequity in access to, and use of, specialized mental health services.

scholarly journals Variation in spend on young mental health across Clinical Commissioning Groups in England: a cross-sectional observational study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e030011 ◽  
Author(s):  
Stephen Rocks ◽  
Mina Fazel ◽  
Apostolos Tsiachristas
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Physical Health ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Young Person ◽  
Cross Sectional ◽  
Adult Mental Health ◽  
Children In Care

ObjectivesTo investigate whether the rate of spend on child and adolescent mental health is influenced by demand for other competing services in local commissioning decisions.DesignAnalysis of spend data by Clinical Commissioning Groups (CCG), including other publicly available data to control for variation in need.SettingLocal commissioning decisions in the National Health Service.ParticipantsCommissioning of health services across 209 CCGs.Main outcome measuresAssociation between the rate of child and adolescent mental health spend and demand for child and adolescent mental health services (CAMHS), adult mental health services and physical health services after adjusting for confounding factors.ResultsAn additional percentage point in the proportion of children in care is associated with 4% higher child and young person mental health (CYP MH) spend per person aged 0–18 (ratio of means: 1.04; 95% CI 1.00 to 1.07). Spending £100 more on physical health services was associated with 9% lower spend in CYP MH per person aged 0–18 (ratio of means: 0.91; 95% CI 0.84 to 0.99).ConclusionsHealthcare commissioners in England face a challenge in balancing competing needs. This paper contributes to our understanding of this by quantifying the possible extent of the trade-off between physical health and CYP MH when allocating budgets. Any attempt to explain the variation in CAMHS spend must also take account of demand for other services.

Help-seeking pathways prior to referral to outpatient child and adolescent mental health services

2021 ◽  
pp. 135910452199419
Author(s):  
Anna Sofie Hansen ◽  
Gry Kjaersdam Telléus ◽  
Emil Færk ◽  
Christina Mohr-Jensen ◽  
Marlene Briciet Lauritsen
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Neurodevelopmental Disorders ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Health Problems ◽  
Educational Services

Aim: To investigate parental help-seeking patterns prior to referral to outpatient child and adolescent mental health services (CAMHS), and whether type of symptoms or duration of mental health problems prior to referral influence help-seeking. Setting: Child mental health services in Denmark involve several sectors collaborating based on stepped-care principles. Access to CAMHS is free of charge but requires a formal referral. Methods: In this cross-sectional observational study, parents of 250 children were interviewed about pathways to outpatient CAMHS using the Children’s Services Interview. Results: The median parent-reported duration of mental health problems prior to referral to CAMHS was 6.0 (IQR 3.4–8.5) years for children referred for neurodevelopmental disorders compared to 2.8 (IQR 1.0–6.5) years for children referred for emotional disorders. Educational services were the first help-seeking contact for the majority (57.5%) but referrals to CAMHS were most frequently from healthcare services (56.4%), predominantly general practitioners. Educational services played a greater part in help-seeking pathways for children referred for neurodevelopmental disorders. Conclusion: The majority of children referred to CAMHS have mental health problems for years before referral. The delay in time-to-referral was most pronounced for children referred for neurodevelopmental disorders. Help-seeking pathways differ by symptom duration and type of symptoms.

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