Approximately half of all lifetime mental disorders emerge in the teenage years, 75% before the age of 25 [1]. In the UK, however, service structure necessitates transition from child and adolescent-centred services by age 18, a period when young people are negotiating multiple physical, emotional and social demands and changes. Around one third of those referred to Adult Mental Health Services may not successful engage (2). This age- rather than needs-based system seems to be ‘weakest where it needs to be strongest’, with ongoing risks to treatment and care [3]. The result is a ‘cliff-edge of lost support’ for 18-year olds [4]. Current service structures offer limited scope to account for an individual’s level of maturity, preparedness, functioning, development, wellbeing or readiness for transition.

Studies suggest that young people might benefit from better preparation for transition – but what preparation do young people want and need to help them navigate this major change?


We are adopting a participatory, collaborative, creative research workshop approach with young CAMHS users and recent leavers in three NHS Trusts. We will run a variety of hands-on, lively activities from brainstorming and body-mapping. Stage one workshops will see young people explore the factors they consider key to transition preparation. In stage two participants will bring together their ideas and recommendations and design a Transition Preparation Programme, probably using mixed media, adaptable for use in CAMH Services throughout the UK.  Young people will lead clinician working lunch sessions to gain their valuable insights and ensure the finished product is service-friendly.


A preparation programme produced by and for young people and tailored to their needs should have considerable future impact. It allows transition to take place when a young person is well-prepared and most able to cope and flourish in the adult world.

Research Partners

Cambridgeshire & Peterborough NHS Foundation Trust, Hertfordshire University Partnership NHS Foundation Trust, Norfolk & Suffolk NHS Foundation Trust, Tom Mellor, independent youth worker/workshop facilitator.

Lead researcher: Valerie Dunn  Research Associate, University of Cambridge, Dept. of Psychiatry/CLAHRC East of England


Evaluation researcher: Caroline Lee, Research Associate, CLAHRC East of England

Workshop facilitator & designer/youth worker: Tom Mellor, independent consultant

More information: 



  1. Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Ustun TB (2007). Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatry, 20:359-364.
  2. Singh SP, Paul M, Ford T, Kramer T, Weaver T. (2008) Transitions of care from Child and Adolescent Mental Health Services to Adult Mental Health Services (TRACK Study): a study of protocols in Greater London. BMC Health Serv Res. 23; 8:135.
  3. McGorry, Bates & Birchwood (2013). Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. The British Journal of Psychiatry, 202: 30-s35
  4. Department of Health: Closing the gap: priorities for essential change in mental health. Closing the gap: priorities for essential change in mental health. City; 2014.
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