Review of evidence on all-age mental health services

The key message is that “optimal transitions” between child and adult mental health services are the exception rather than the rule. This is supported in the main by data from the qualitative research for this review in Wales. The reasons for this include:

• the timing of the transition which often comes at a particularly vulnerable point in young people’s lives
• the fear and anxiety associated with the transition. Child and Adolescent Mental Health Services (CAMHS) may have offered safety and support during a very difficult period in young people’s lives
• the cultural, structural and organisational differences between CAMHS and AMHS

Good practice in transitions

Research across the UK and the interviews conducted here consistently identify a range of factors that support transitions from CAMHS; they include:

• ensuring and supporting the transition to AMHS where available, and identifying alternative services where this is not possible. Services should proactively reach out to engage with young people and their families, particularly those most at risk of disengagement
• providing information and support for young people and their families before and during the transition process
• collaborative working between CAMHS and AMHS. This should include starting transition planning early, and planning effectively to ensure that young people, their families and services are prepared
• flexibility that enables person, rather than service, centred approaches to transitions and care
• ensuring that both CAMHS and AMHS get “the simple things right
• using effective monitoring and evaluation of users’ experiences of transition and the continuity of care provided to inform service development

Recommendations for further research

This was a relatively small scale scoping study, intended to identify the need for further research. The key gaps it highlights are identifying:

• the barriers to implementing the current T4CYP guidance on transitions and solutions (to ensure consistent implementation across Wales)
• the effectiveness and cost-effectiveness of, and lessons from, the establishment of alternative service models.
• assessing the case for and against developing young people’s MH services, including considering the appropriate age range for services