Emerging Mood and Anxiety Disorders: Lost in Transition

Presentation First Author: 
Swaran P Singh

Background: Many adolescents with mental health problems experience transition of care from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS). As part of the multisite TRACK study we evaluated the process, outcomes and user and carer experience of transition from CAMHS to AMHS in six large mental health Trusts in England. Method: We identified a cohort of service users (n=154) crossing the CAMHS/AMHS boundary over one year and tracked their transition journey. We determined predictors of optimal transition and conducted qualitative interviews with a subsample of users, their carers and clinicians on how transition was experienced. Optimal transition was defined as adequate transition planning, good information transfer across teams, joint working between teams and continuity of care following transition. Results: Of the 154 young people of reaching transition boundary, 78 (50.6%) had emerging emotional and neurotic disorders, mainly depression and anxiety. Of there only about half were referred to AMHS; however a fifth were discharged without ever being seen by AMHS. A diagnosis of emerging mood and anxiety disorder was associated with sub-optimal transition (OR 0.34, 95%CI 0.12, 0.96). Overall, less than 5% of the sample experienced optimal transition. Conclusion: For the vast majority of service users, transition from CAMHS to AMHS is poorly planned, poorly executed and poorly experienced. Young people with emerging mood and personality disorders achieve optional transition of care and many simply fall through the care gap. Their outcomes and wellbeing should be a major cause of concern.

Conference Name: 
Presentation Date: 
January, 2015
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