Predictors of transitioning to adult mental health services and associated costs: a cross-country comparison

Abstract

BackgroundYoung people are at risk of falling through the care gap after leaving child and adolescent mental health services (CAMHS) despite an ongoing need for mental health support. Currently, little is known about the predictors of transitioning to adult mental health services (AMHS), and associated healthcare and societal costs as young people cross the transition boundary.ObjectiveTo conduct a secondary data analysis exploring predictors of transitioning or falling through the gap and associated costs.MethodsData were used from a longitudinal study, which followed young people from seven European countries for 2 years after reaching their CAMHS boundary. Predictors of transitioning (including sociodemographic and clinical variables) and longitudinal resource use were compared for 488 young people who transitioned to AMHS versus those who fell through the gap.FindingsYoung people were more likely to transition to AMHS if they were severely ill. Those from Italy, the Netherlands and the UK were more likely to fall through the gap than transition to AMHS. Healthcare costs fell for all young people over the study, with a sharper decrease for those who fell through the gap.ConclusionsTotal healthcare costs fell for all participants, indicating that the intensity of mental health support reduces for all young people as they cross the CAMHS boundary, regardless of clinical need.Clinical implicationsIt is important that alternative forms of mental health support are available for young people who do not meet the AMHS care threshold but still have mental health needs after leaving CAMHS.

The Transition from adolescence to adulthood mental health services for young people with ADHD in Italy

“…Low referral acceptance and lack of communication between CAHMS and AMHS contribute to the loss of care for approximately half of patients. Such mechanisms result from scarce services and resources, as previously highlighted elsewhere (Eke et al ., 2020; Appleton et al ., 2023; Roberti et al ., 2023b).…”

Ensuring continuity of care for young people transitioning to adult mental health services: issues faced and promising approaches

“…Some clinical groups are more likely than others to fall through the gap between services (McNicholas et al, 2015). Comparing characteristics between those who transitioned and those who fell through the gap, it was found that only the most severely ill transitioned to AMHS (Appleton et al, 2023), which is in line with findings from other studies (Singh et al, 2008;McNicholas et al, 2015;Gerritsen et al, 2022). Findings from a qualitative interview study showed that young people fell through the gap because of a variety of systemic factors, such as a lack of joined-up care between services, not meeting the illness EDITORIAL © 2024 MA Healthcare Ltd threshold to be eligible for care at AMHS, and a lack of alternative available forms of support (Appleton et al, 2021).…”