Project title: Transition from Child & Adolescent Mental Health Services (CAMHS): users and leavers co-produce a transition preparation programme 

Background:

Consensus is growing that a rigid, age-based cut-off for leaving Child and Adolescent Mental Health Services (CAMHS) is not in the best interests of young people (YP). The Care Act 2014, recognises that transitions must be flexible, and Department of Health guidance (Future in Mind, 2015) recommends a flexible transition age, where decisions are based on individual need and circumstance rather than age alone. Meanwhile, in most regions of the United Kingdom, young people attending Child and Adolescent Mental Health Services (CAMHS) are discharged or transferred to an adult service at age 17, or 18 at the latest.
This transition is often poorly managed and young people tend to have poor experiences of this change. A transition that has been stressful, can lead to negative outcomes in young people.

The aim of this study was to improve the experience and outcomes for young people who are leaving Child and Adolescent Mental Health Services (CAMHS). The CAMHS Transition Preparation Project (TPP) brought together young people service users and leavers, as well as NHS practitioners and researchers, to explore what CAMHS transition preparation might involve and to co-devise a practical Transition Preparation Programme.

Methodology:

This was an exploratory, development study. The team worked with three NHS Trusts: Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), Norfolk and Suffolk NHS Foundation Trust (NSFT) and Hertfordshire Partnership NHS Foundation Trust (HPFT). Participants, aged 16-23 years, were recruited via  each Trust’s Participation/Inclusion network. They ran active, collaborative and creative two-day workshops in each trust for 6-10 young people.

Workshops were organised in two stages.

  • The first looked at what factors; both person and service-centred, young people thought were most influential in preparation for transition
  • The second looked at how best to deliver, design and incorporate the most important factors into a TPP.

Young people co-hosted clinician working lunch sessions in each trust to incorporate clinician views and opinions.

Workshops were co-facilitated and designed by Tom Mellor (Cambs County Council Youth Offending Service) and Valerie Dunn. The process was evaluated by Caroline Lee, Research Associate, CLAHRC EoE.

Participants included 18 young people attending and leaving CAMHS and 30 mental health practitioners from three NHS Foundation Trusts in Cambridgeshire/Peterborough, Hertfordshire and Norfolk/Suffolk. All participants were give written, informed consent and procedures were given ethical approval.

Key findings and outputs:

The young people’s primary recommendations to improve preparation for transition were:

  • dedicated transition peer support workers,
  • a personalised transition workbook, and
  • a range of information including virtual ‘podwalk’ tours of mental health clinics.
Initial outputs included:
  • In Hertfordshire Partnership NHS Foundation Trust (HPFT):
    a. Pre and post-transition surveys have been developed,
    b. A transition booklet is being created
  • In Cambridgeshire and Peterborough NHS Foundation Trust (CPFT)
    a. Three peer support workers and two Band 6 transition workers have been employed to support the transition of young people into adult services,
    b. Young people have filmed and published a virtual tour of Adult Mental Health Services https://www.youtube.com/embed/FFOTSN29hfU
    c. A transitions booklet has been developed and published,
    d. Interface meetings between CAMHS and adult teams have been introduced to discuss individuals’ transitions.
  • The CPFT transitions booklet has been part of the transitions CQUIN in both CPFT and NHS England

Publications:

Allan, S., Davis-Steel, K., Dunn, F. and Dunn, V. ‘Young people and an NHS participation worker reflect on their involvement in a creative, collaborative mental health research project’. Research for All. 2017 1 (2): 300–6. DOI https://doi.org/10.18546/RFA.01.2.06

Dunn V. Young people, mental health practitioners and researchers co-produce a Transition Preparation Programme to improve outcomes and experience for young people leaving Child and Adolescent Mental Health Services (CAMHS). 2017. BMC Health Services Research. 17(1):293. doi: 10.1186/s12913-017-2221-4.

BITE: For a ‘BITE’ sized summary of the research, please see: Transitions BITE sized summary May 2016

For further information on this project, contact Valerie Dunn at Valerie.dunn@education.ox.ac.uk

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