Transition of young people from CAMHS to AMH 2017-19

AimsTransition from CAMHS to AMH is recognised as a potential struggle for young people who suffer with poor mental health. In response to the 2017-19 NHS CQUIN project, LPT organised a monthly working group to establish the best transition process & deliver the CQUIN project.BackgroundIt is estimated that more than 25,000 young people transition each year. It is reported that this process is often handled poorly, which can result in repeat assessments and emergency admissions for this large cohort of service users at a critical stage in life. The result is that young may go on to develop more severe problems in the absence of an appropriate transition service.MethodCohort of service users eligible for transition (17yrs 6months) was identified. They were referred from CAMHS to AMH with a transition plan and referral letter. A face-to-face transition meeting was arranged which included the patient, carer & clinicians from sending & receiving services. A clinical audit was completed to ensure that care was transferred to AMH post-18th birthday of the patient. The process was followed up by pre- and post-transitions surveys.ResultFrom 110 identified service users 46% had joint-agency transition meeting and 79% had transition plan in place. 72% felt prepared to transition to AMH and 89% felt their transition goals were met. Positive comments have been received from service users.ConclusionLink workers were identified to facilitate the transition process. Flow chart was established and disseminated across LPT. Services that need an improvement will be targeted and monitored. LPT will host an event for patients and carers to involve them in enhancing the transition process.

Demographic and Transition Service Predictors of Employment Outcomes for Youth Receiving Supplemental Security Income

Racially and ethnically diverse youth with disabilities receiving Supplemental Security Income (SSI) benefits were randomly assigned to usual services, including available school and vocational rehabilitation (VR) transition services, or enhanced case management and transition services through the Wisconsin Promoting Readiness of Minors in SSI (PROMISE) federal demonstration grant. A hierarchical logistic regression analysis demonstrated increased age, being African American, having a psychiatric disability, and transition services predicted higher youth employment rates. However, enhanced PROMISE transition services were no longer significant in the presence of VR services, suggesting the effect of enhanced services was mediated by increasing engagement in VR. Limitations and implications are discussed regarding the relationship between school and state VR transition services and postsecondary competitive integrated employment outcomes.

Transition for patients with congenital heart disease in the UK: need for a universal model with adequate training and support

Background Adolescence is a vulnerable period for patients with congenital heart disease (CHD). Transition is a process that guides these patients through adolescence and ensures a smooth transfer to adult services, in order improve adherence to medical care and reduce loss to follow-up. While the importance of a formal Transition process is widely recognised and a requirement for specialist services in the UK, the optimal structure and delivery of Transition remains a matter of debate. Aims To examine the different models of Transition currently in place in specialist CHD centres around the UK. Methods A survey of Adult CHD centres in the UK was performed. A focus was placed on the structure of the Transition service, relevant training and areas of perceived improvement. Results There were 10 responses to our survey covering 10 specialist CHD centres. All respondents were consultant adult CHD specialists, looking after patients from the age of 16 [14–17] years. All centres have a specialised Transition service, which runs from the age 13 [11–15] to 18 [16–25] years (duration of transition 5 [2–13] years). The majority of centres (80%) report providing transition care “well before” transfer to adult care, whereas 20% provide transition care at or immediately before transfer (i.e. first adult CHD appointment). Transition is delivered by physicians and clinical specialist nurses in approximately equal numbers in 9 (90%) centres and exclusively by clinical nurse specialists in 1 (10%) centre. A median of 2 [1–5] visits are planned for each patient, with 7 (70%) centres seeing patients at least twice during transition. The majority, but not all centres (70%) provide a health passport during transition. A significant number of centres felt they werer not receiving sufficient support in the following domains: financial (50%), training (30%), clinical space (30%), referrals from paediatrics (50%). All respondents felt that their Transition service had room for improvement. Other areas of improvement highlighted included reduction in loss to follow-up, difficulties in providing a Transition service to patients followed in peripheral hospitals, the need for more support from paediatric services in referring all appropriate patients, and dedicated administrative support. The vast majority of respondents (9, 90%) felt equipped with the appropriate skills to care for transition patients. However, few (2, 20%) had completed formal training in more than one area related to adolescent health and transition. Conclusions While all CHD centres have a Transition service, Transition models and delivery differs significantly. There is urgent need for research in this area to develop a unified model, greater financial support and relevant training to optimise care. Figure 1. Participating UK centres Funding Acknowledgement Type of funding source: None

Partnerships From the Pews: Promoting Interagency Collaboration With Religious Organizations

Religious organizations often serve as mainstays of communities, especially rural communities with otherwise limited support to promote improved transition outcomes. Yet, religious organizations appear not to be utilized as agencies in transition service partnerships. This article addresses involving religious organizations in the transition process through interagency collaboration by providing strategies, supported by literature, for engaging religious organizations as collaborative partners for community-based instruction and skill development opportunities for students preparing for adult life. Suggestions demonstrate how religious organizations and school systems can have mutually beneficial partnerships.