Factors associated with the transition of adolescent inpatients from an intensive residential ward to adult mental health services

Pontoni, Giancarlo; Pietro, Elena Di; Neri, Tommaso; Mattei, Giorgio; Longo, Fedora; Neviani, Vittoria; Neri, Giovanni; Stagi, Paolo; Caffo, Ernesto; Starace, Fabrizio; Galeazzi, Gian Maria

doi:10.1007/s00787-020-01717-y

Cited by 9 publications

(12 citation statements)

References 35 publications

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“…Previous research reports a large variation in the proportion of CAMHS users that do not transition to AMHS, ranging from 30% to 84%. [3][4][5][6][7][8][9] There are a few studies examining how demographic and clinical characteristics of CAMHS users are associated with transitioning to AMHS. These studies are consistent in showing that indicators of severity of psychopathology, such as a clinical classification of a bipolar or psychotic disorder, inpatient care and psychotropic medication use, are associated with a greater likelihood of transition to AMHS.…”

Section: Introductionmentioning

confidence: 99%

Cohort profile: demographic and clinical characteristics of the MILESTONE longitudinal cohort of young people approaching the upper age limit of their child mental health care service in Europe

Gerritsen¹,

Maras²,

Bodegom³

et al. 2021

BMJ Open

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PurposeThe presence of distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) impacts continuity of mental health treatment for young people. However, we do not know the extent of discontinuity of care in Europe nor the effects of discontinuity on the mental health of young people. Current research is limited, as the majority of existing studies are retrospective, based on small samples or used non-standardised information from medical records. The MILESTONE prospective cohort study aims to examine associations between service use, mental health and other outcomes over 24 months, using information from self, parent and clinician reports.ParticipantsSeven hundred sixty-three young people from 39 CAMHS in 8 European countries, their parents and CAMHS clinicians who completed interviews and online questionnaires and were followed up for 2 years after reaching the upper age limit of the CAMHS they receive treatment at.Findings to dateThis cohort profile describes the baseline characteristics of the MILESTONE cohort. The mental health of young people reaching the upper age limit of their CAMHS varied greatly in type and severity: 32.8% of young people reported clinical levels of self-reported problems and 18.6% were rated to be ‘markedly ill’, ‘severely ill’ or ‘among the most extremely ill’ by their clinician. Fifty-seven per cent of young people reported psychotropic medication use in the previous half year.Future plansAnalysis of longitudinal data from the MILESTONE cohort will be used to assess relationships between the demographic and clinical characteristics of young people reaching the upper age limit of their CAMHS and the type of care the young person uses over the next 2 years, such as whether the young person transitions to AMHS. At 2 years follow-up, the mental health outcomes of young people following different care pathways will be compared.Trial registration numberNCT03013595.

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Section: Introductionmentioning

confidence: 99%

Cohort profile: demographic and clinical characteristics of the MILESTONE longitudinal cohort of young people approaching the upper age limit of their child mental health care service in Europe

Gerritsen¹,

Maras²,

Bodegom³

et al. 2021

BMJ Open

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“…Moreover, while it seems that previously hospitalized adolescents have a 50% chance of being successfully transferred to an AMHS and that higher engagement was witnessed within the rst two years [24], this rate was limited to a narrow territory (i.e., the Province of Modena). No studies considered the professionals' opinion, nor did they cover the whole national territory.…”

Section: Discussionmentioning

confidence: 99%

“…Although some guidelines exist in many countries (e.g., the NICE guidelines in the UK), their e cacy and generalizability have not yet been accurately evaluated. In Italy, only two studies have assessed the situation, one at the single province level (i.e., Modena) (Pontoni et al, 2022), and one at the regional level for the Lombardy Region . The latter involved a total of 18 services in an exploratory study investigating the health care management and continuity for young adults with ADHD.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, it stands as the starting point for future work. Pontoni and colleagues (2022) observed that greater engagement toward a successful transition is witnessed within the rst two years [24]. We therefore plan to involve individual stakeholders from across Italy, including patients, parents or caregivers, clinicians from CAMHS and AMHS, and possibly general practitioners [25] in de ning standard guidelines that can facilitate a successful transition within the outlined 2-year time window.…”

Section: Discussionmentioning

confidence: 99%

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Transitioning to Adult Mental Health Services for young people with ADHD: an Italian-based Survey on practices for Pediatric and Adult Services

Roberti

Scarpellini

Campi

et al. 2023

Preprint

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The present study assessed the transitioning process of Attention-Deficit/Hyperactivity Disorder (ADHD) patients in Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) in the Italian territory. We asked child and adult psychiatrists to report the current state of services and their observations on limitations and possible future matters that need to be addressed. Seventy-seven centers (42 CAMHS, 35 AMHS) filled in a web-based survey in which they reported the number of ADHD patients, how many transitioning patients they had within the past year, and how they structured transition. A fragmented picture emerged from the survey. Lack of resources, training, and communication between services hinder the transition process, and many adult patients remain under CAMHS' care. While some services have a protocol, there is no structured guidance that can help improve integration and continuity of treatment. The observed situation reflects a need for improvement and for standard guidelines to enable a successful transition process, considering both clinicians' and patients' necessities.

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“…With the present study, we aim to fill this gap by considering the opinion of professionals working with transitioning ADHD patients in the Italian territory. In Italy, only two studies have assessed the situation, one at the single province level (i.e., Modena) [ 22 ], and one at the regional level for the Lombardy Region [ 23 ]. The latter involved a total of 18 services in an exploratory study investigating the health care management and continuity for young adults with ADHD.…”

Section: Introductionmentioning

confidence: 99%

Transitioning to adult mental health services for young people with ADHD: an Italian-based survey on practices for pediatric and adult services

Roberti,

Scarpellini,

Campi

et al. 2023

Child Adolesc Psychiatry Ment Health

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Background Supporting young ADHD patients in transition to adult services is essential. Yet, the low percentages of successful referrals and the issues reported by patients and clinicians stress the need for further attention to transitioning practices. The present study assessed the transitioning process of Attention-Deficit/Hyperactivity Disorder (ADHD) patients in Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) in the Italian territory. We asked child and adult psychiatrists to report the current state of services and their observations on limitations and possible future matters that must be addressed. Method Seventy-seven centers (42 CAMHS, 35 AMHS) filled in a web-based survey in which they reported the number of ADHD patients, how many transitioning patients they had within the past year, and how they structured transition. Results A fragmented picture emerged from the survey. Lack of resources, training, and communication between services hinder the transition process, and many adult patients remain under CAMHS’ care. While some services have a protocol, there is no structured guidance that can help improve integration and continuity of treatment. Conclusion The observed situation reflects a need for improvement and standard guidelines to enable a successful transition process, considering clinicians' and patients’ necessities.

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Factors associated with the transition of adolescent inpatients from an intensive residential ward to adult mental health services

Cited by 9 publications

References 35 publications

Cohort profile: demographic and clinical characteristics of the MILESTONE longitudinal cohort of young people approaching the upper age limit of their child mental health care service in Europe

Cohort profile: demographic and clinical characteristics of the MILESTONE longitudinal cohort of young people approaching the upper age limit of their child mental health care service in Europe

Transitioning to Adult Mental Health Services for young people with ADHD: an Italian-based Survey on practices for Pediatric and Adult Services

Transitioning to adult mental health services for young people with ADHD: an Italian-based survey on practices for pediatric and adult services

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