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. 2021 Mar;30(3):401-413.
doi: 10.1007/s00787-020-01526-3. Epub 2020 Apr 9.

"I'm just a long history of people rejecting referrals" experiences of young people who fell through the gap between child and adult mental health services

Rebecca Appleton  1 , Farah Elahi  2 , Helena Tuomainen  2 , Alastair Canaway  2 , Swaran P Singh  2
Affiliations

"I'm just a long history of people rejecting referrals" experiences of young people who fell through the gap between child and adult mental health services

Rebecca Appleton et al. Eur Child Adolesc Psychiatry. 2021 Mar.

Abstract

The paediatric-adult split in mental health care necessitates young people to make a transition between services when they reach the upper end of child and adolescent mental health services (CAMHS). However, we know that this transition is often poor, and not all young people who require ongoing support are able to continue care in adult mental health services (AMHS). These young people are said to have fallen through the gap between services. This research aimed to explore the reasons why young people fall through the gap between CAMHS and AMHS, and what effect this has had on them and their families. Narrative interviews were conducted with 15 young people and 15 parents, representing 19 unique transition stories. Themes were identified collaboratively using thematic analysis. Reasons for falling through the gap were grouped into systemic problems and problems with the quality of care received. Effects of falling through the gap were grouped into separate themes for young people (feeling abandoned; struggling to manage without continued care; problems with medication) and parents (emotional impact of care ending; parents taking an active role in the young person's care). To our knowledge, this is the first qualitative study that has focused only on the experiences of young people who have fallen through the gap between services. This research adds novel findings to existing literature regarding barriers to transition and the effects of discontinuity of care.

Keywords: AMHS; CAMHS; Narrative research; Qualitative research; Transition.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Topics and example questions used in narrative interviews with young people
Fig. 2
Fig. 2
Diagram showing the themes and subthemes for young people and parents views as to why young people fell through the gap between services
Fig. 3
Fig. 3
Diagram showing the themes for the effects of falling through the gap between services
See this image and copyright information in PMC

References

    1. Blum RW, Garell D, Hodgman CH, Jorissen TW, Okinow NA, Orr DP, et al. Transition from child-centered to adult health-care systems for adolescents with chronic conditions. A position paper of the Society for Adolescent Medicine. J Adolesc Health Off Publ Soc Adolesc Med. 1993;14(7):570–576. doi: 10.1016/1054-139X(93)90143-D. - DOI - PubMed
    1. Murcott W. Transitions between child and adult mental health services: service design, philosophy and meaning at uncertain times. J Psychiatr Ment Health Nurs. 2014;21(7):628–634. doi: 10.1111/jpm.12150. - DOI - PubMed
    1. Singh SP, Paul M, Ford T, Kramer T, Weaver T, McLaren S, et al. Process, outcome and experience of transition from child to adult mental healthcare: multiperspective study. Br J Psychiatry. 2010;197(4):305–312. doi: 10.1192/bjp.bp.109.075135. - DOI - PubMed
    1. Hovish K, Weaver T, Islam Z, Paul M, Singh SP. Transition experiences of mental health service users, parents, and professionals in the United Kingdom: a qualitative study. Psychiatr Rehabil J. 2012;35(3):251. doi: 10.2975/35.3.2012.251.257. - DOI - PubMed
    1. Butterworth S, Singh SP, Birchwood M, Islam Z, Munro ER, Vostanis P, et al. Transitioning care-leavers with mental health needs: ‘they set you up to fail!’. Child Adolesc Mental Health. 2017;22(3):138–147. doi: 10.1111/camh.12171. - DOI - PubMed

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