Comparison of child and adult clinicians’ perceptions of barriers and facilitators to effective care transition

“There wasn’t any build up to it, it was just like, now you have to go over.” Disengagement during the Child to Adult Community Mental Health Service Transition

“…And, third, recent research has highlighted how providers felt constrained by the system (e.g., eligibility criteria, funding rules, etc.) and were unaware of simple process changes that could be made within the organization to better serve emerging adults (Borah et al, 2021). For example, completing the state-mandated adult system forms with child providers and transferring youth to a new adult service program instead of discharging youth at 17.9 years of age from child services, and requiring new state-mandated forms to enroll in adult services.…”

“…The British Youth Council described the transition out of child mental health services as a “cliff edge” that can cause AYA to relapse or disengage from services (2015). Child and adult mental health service systems are often siloed and disconnected, working independently from one another and providing considerably different treatment methods and services (Borah et al, 2021; McGorry et al, 2013; Munson et al, 2012; Singh & Tuomainen, 2015). Child and adult mental health systems have different cultures (Hovish et al, 2012; Jivanjee & Kruzich, 2011; Muñoz-Solomando et al, 2010).…”

“…Child and adult mental health systems have different cultures (Hovish et al, 2012; Jivanjee & Kruzich, 2011; Muñoz-Solomando et al, 2010). AYA report notable differences between child and adult care philosophies (e.g., emphasis on family unit versus emphasis on adult autonomy) and a shift from a more nurturing environment in child system to a more impersonal environment in the adult system (Borah et al, 2021; Broad et al, 2017). Child and adult providers typically minimally collaborate with each other to support transitions from child to adult mental health systems (Borah et al, 2021; McGorry et al, 2013).…”

“…A parallel study by the authors found that child and adult mental health treatment providers describe the transition experience into adult services as overwhelming, challenging and ultimately stigmatizing for AYA (Borah et al, 2021). AYA grieve the loss of familiar child-system treatment surroundings and provider relationships and would prefer the adult system be more sensitive to their complex developmental needs (Betz et al, 2013; Fegran et al, 2014).…”

Mental Health Service Experiences Among Transition-Age Youth: Interpersonal Continuums that Influence Engagement in Care

“…Service cost is another systemic barrier to service use (Booth et al, 2004 ), especially considering that TAY are in the age group (19–34 year olds) with the highest uninsured rate at 15.6% (Conway, 2020 ). TAY mental health service providers echo these barriers and highlight additional barriers, including TAY lack of knowledge, stigma about mental health, lack of services, lack of TAY-friendly environments, and organizational processes (e.g., time constraints, limited TAY involvement in service development; Borah et al, 2021 ; Goodcase et al, 2021 ; Platell et al, 2017 ).…”