. 2022 May;57(5):973-991.

doi: 10.1007/s00127-022-02238-6. Epub 2022 Feb 10.

Demographic, clinical, and service-use characteristics related to the clinician's recommendation to transition from child to adult mental health services

S E Gerritsen^#¹, L S van Bodegom^#^{1

2}, G C Dieleman³, M M Overbeek^{2

4}, F C Verhulst^{1

5}, D Wolke⁶, D Rizopoulos⁷, R Appleton⁸, T A M J van Amelsvoort^{9

10}, C Bodier Rethore¹¹, F Bonnet-Brilhault¹¹, I Charvin¹², D Da Fonseca¹², N Davidović^{13

14}, K Dodig-Ćurković^{15

16

17}, A Ferrari^{18

19}, F Fiori^{20

21

22}, T Franić^{13

14}, C Gatherer²³, G de Girolamo¹⁸, N Heaney²⁰, G Hendrickx²⁴, R Jardri²⁵, A Kolozsvari²², H Lida-Pulik²⁶, K Lievesley²⁰, J Madan²⁷, M Mastroianni^{20

21}, V Maurice²⁸, F McNicholas^{29

30}, R Nacinovich^{31

32}, A Parenti³³, M Paul^{23

34}, D Purper-Ouakil^{28

35}, L Rivolta^{36

37}, V de Roeck^{38

39}, F Russet²⁸, M C Saam⁴⁰, I Sagar-Ouriaghli²⁰, P J Santosh^{20

21

22}, A Sartor⁴¹, U M E Schulze⁴⁰, P Scocco^{42

43}, G Signorini¹⁸, S P Singh²³, J Singh^{20

21}, M Speranza^{35

44}, P Stagi⁴⁵, P Stagni^{18

46}, C Street²³, P Tah²³, E Tanase⁴⁷, S Tremmery³⁸, A Tuffrey²³, H Tuomainen²³, L Walker²³, A Wilson²³, A Maras^{1

2}; Milestone Consortium

Collaborators, Affiliations

Collaborators

Milestone Consortium:
Laura Adams, Giovanni Allibrio, Marco Armando, Sonja Aslan, Nadia Baccanelli, Monica Balaudo, Fabia Bergamo, Angelo Bertani, Jo Berriman, Albert Boon, Karen Braamse, Ulrike Breuninger, Maura Buttiglione, Sarah Buttle, Aurélie Schandrin, Marco Cammarano, Alastair Canaway, Fortunata Cantini, Cristiano Cappellari, Marta Carenini, Giuseppe Carrà, Cecilia Ferrari, Krizia Chianura, Philippa Coleman, Annalisa Colonna, Patrizia Conese, Raffaella Costanzo, Claire Daffern, Marina Danckaerts, Andrea de Giacomo, Jean-Pierre Ermans, Alan Farmer, Jörg M Fegert, Sabrina Ferrari, Giuliana Galea, Michela Gatta, Elisa Gheza, Giacomo Goglia, MariaRosa Grandetto, James Griffin, Flavia Micol Levi, Véronique Humbertclaude, Nicola Ingravallo, Roberta Invernizzi, Caoimhe Kelly, Meghan Killilea, James Kirwan, Catherine Klockaerts, Vlatka Kovač, Ashley Liew, Christel Lippens, Francesca Macchi, Lidia Manenti, Francesco Margari, Lucia Margari, Paola Martinelli, Leighton McFadden, Deny Menghini, Sarah Miller, Emiliano Monzani, Giorgia Morini, Todor Mutafov, Lesley O'Hara, Cristina Negrinotti, Emmanuel Nelis, Francesca Neri, Paulina Nikolova, Marzia Nossa, Maria Giulia Cataldo, Michele Noterdaeme, Francesca Operto, Vittoria Panaro, Adriana Pastore, Vinuthna Pemmaraju, Ann Pepermans, Maria Giuseppina Petruzzelli, Anna Presicci, Catherine Prigent, Francesco Rinaldi, Erika Riva, Anne Roekens, Ben Rogers, Pablo Ronzini, Vehbi Sakar, Selena Salvetti, Ottaviano Martinelli, Tanveer Sandhu, Renate Schepker, Marco Siviero, Michael Slowik, Courtney Smyth, Patrizia Conti, Maria Antonietta Spadone, Fabrizio Starace, Patrizia Stoppa, Lucia Tansini, Cecilia Toselli, Guido Trabucchi, Maria Tubito, Arno van Dam, Hanne van Gutschoven, Dirk van West, Fabio Vanni, Chiara Vannicola, Cristiana Varuzza, Pamela Varvara, Patrizia Ventura, Stefano Vicari, Stefania Vicini, Carolin von Bentzel, Philip Wells, Beata Williams, Marina Zabarella, Anna Zamboni, Edda Zanetti

Affiliations

¹ Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands.
² Yulius Academy, Yulius Mental Health Organization, Dordrecht, The Netherlands.
³ Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands. g.dieleman@erasmusmc.nl.
⁴ Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
⁵ Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
⁶ Department of Psychology, University of Warwick, Coventry, UK.
⁷ Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.
⁸ NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK.
⁹ Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, The Netherlands.
¹⁰ Mondriaan Mental Health Care, Heerlen, The Netherlands.
¹¹ Centre Hospitalier Universitaire de Tours, Tours, France.
¹² Centre Hospitalier Universitaire de Marseille, Marseille, France.
¹³ University Hospital Split, Split, Croatia.
¹⁴ School of Medicine, University of Split, Split, Croatia.
¹⁵ Faculty for Dental Care and Health, Osijek, Croatia.
¹⁶ University Health Center Osijek, Osijek, Croatia.
¹⁷ Unit for Child and Adolescent Psychiatry, Osijek, Croatia.
¹⁸ IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
¹⁹ DISM, ULSS 16, SOPROXI Onlus, Padua, Italy.
²⁰ Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.
²¹ Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK.
²² HealthTracker Ltd, Kent, UK.
²³ Warwick Medical School, University of Warwick, Coventry, UK.
²⁴ Department of Neurosciences, Centre for Clinical Psychiatry, KU Leuven, Leuven, Belgium.
²⁵ Lille Neurosciences and Cognitions, Plasticity and Subjectivity Team, CURE Platform, Université de Lille, INSERM (U-1172), Fontan Hospital, CHU Lille, Lille, France.
²⁶ CH Versailles, Versailles, France.
²⁷ Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
²⁸ Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France.
²⁹ School of Medicine & Medical Science, University College Dublin, Dublin, Republic of Ireland.
³⁰ Lucena CAMHS, SJOG, Dublin, Republic of Ireland.
³¹ Child and Adolescent Neuropsychiatry Unit, ASST Monza, Monza, Italy.
³² Università Degli Studi Milano Bicocca, Milan, Italy.
³³ Centre Hospitalier Universitaire de Lille, Lille, France.
³⁴ Coventry and Warwickshire Partnership NHS Trust, Coventry, UK.
³⁵ INSERM, CESP U1018, PsyDev, University Paris Saclay, UVSQ, Versailles, France.
³⁶ Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy.
³⁷ Department of Mental Health, Psychiatry Unit, San Gerardo Hospital, Monza, Monza Brianza, Italy.
³⁸ Department of Neurosciences, KU Leuven, Leuven, Belgium.
³⁹ Child and Youth Studies, Campus Social School, University Colleges Leuven Limburg, Heverlee, Belgium.
⁴⁰ Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.
⁴¹ Josefinum Augsburg, Klinik für Kinder- und Jugenspsychiatrie und Psychotherapie, Augsburg, Germany.
⁴² Department of Mental Health, ULSS 6 Euganea, Padua, Italy.
⁴³ SOPROXI Onlus, Padua, Italy.
⁴⁴ Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier de Versailles, Versailles, France.
⁴⁵ Child and Adolescent Neuropsychiatry Unit, AUSL Modena, Modena, Italy.
⁴⁶ Child and Adolescent Neuropsychiatry, Department of Mental Health, Modena, Italy.
⁴⁷ Abteilung für Psychiatrie und Psychotherapie des Kindes-und Jugendalters Weissenau, ZfP Südwürttemberg, Ravensburg, Germany.

^# Contributed equally.

PMID: 35146551
PMCID: PMC9042957
DOI: 10.1007/s00127-022-02238-6

Demographic, clinical, and service-use characteristics related to the clinician's recommendation to transition from child to adult mental health services

S E Gerritsen et al. Soc Psychiatry Psychiatr Epidemiol. 2022 May.

. 2022 May;57(5):973-991.

doi: 10.1007/s00127-022-02238-6. Epub 2022 Feb 10.

Authors

Collaborators

Milestone Consortium:
Laura Adams, Giovanni Allibrio, Marco Armando, Sonja Aslan, Nadia Baccanelli, Monica Balaudo, Fabia Bergamo, Angelo Bertani, Jo Berriman, Albert Boon, Karen Braamse, Ulrike Breuninger, Maura Buttiglione, Sarah Buttle, Aurélie Schandrin, Marco Cammarano, Alastair Canaway, Fortunata Cantini, Cristiano Cappellari, Marta Carenini, Giuseppe Carrà, Cecilia Ferrari, Krizia Chianura, Philippa Coleman, Annalisa Colonna, Patrizia Conese, Raffaella Costanzo, Claire Daffern, Marina Danckaerts, Andrea de Giacomo, Jean-Pierre Ermans, Alan Farmer, Jörg M Fegert, Sabrina Ferrari, Giuliana Galea, Michela Gatta, Elisa Gheza, Giacomo Goglia, MariaRosa Grandetto, James Griffin, Flavia Micol Levi, Véronique Humbertclaude, Nicola Ingravallo, Roberta Invernizzi, Caoimhe Kelly, Meghan Killilea, James Kirwan, Catherine Klockaerts, Vlatka Kovač, Ashley Liew, Christel Lippens, Francesca Macchi, Lidia Manenti, Francesco Margari, Lucia Margari, Paola Martinelli, Leighton McFadden, Deny Menghini, Sarah Miller, Emiliano Monzani, Giorgia Morini, Todor Mutafov, Lesley O'Hara, Cristina Negrinotti, Emmanuel Nelis, Francesca Neri, Paulina Nikolova, Marzia Nossa, Maria Giulia Cataldo, Michele Noterdaeme, Francesca Operto, Vittoria Panaro, Adriana Pastore, Vinuthna Pemmaraju, Ann Pepermans, Maria Giuseppina Petruzzelli, Anna Presicci, Catherine Prigent, Francesco Rinaldi, Erika Riva, Anne Roekens, Ben Rogers, Pablo Ronzini, Vehbi Sakar, Selena Salvetti, Ottaviano Martinelli, Tanveer Sandhu, Renate Schepker, Marco Siviero, Michael Slowik, Courtney Smyth, Patrizia Conti, Maria Antonietta Spadone, Fabrizio Starace, Patrizia Stoppa, Lucia Tansini, Cecilia Toselli, Guido Trabucchi, Maria Tubito, Arno van Dam, Hanne van Gutschoven, Dirk van West, Fabio Vanni, Chiara Vannicola, Cristiana Varuzza, Pamela Varvara, Patrizia Ventura, Stefano Vicari, Stefania Vicini, Carolin von Bentzel, Philip Wells, Beata Williams, Marina Zabarella, Anna Zamboni, Edda Zanetti

Affiliations

¹ Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands.
² Yulius Academy, Yulius Mental Health Organization, Dordrecht, The Netherlands.
³ Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands. g.dieleman@erasmusmc.nl.
⁴ Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
⁵ Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
⁶ Department of Psychology, University of Warwick, Coventry, UK.
⁷ Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.
⁸ NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK.
⁹ Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, The Netherlands.
¹⁰ Mondriaan Mental Health Care, Heerlen, The Netherlands.
¹¹ Centre Hospitalier Universitaire de Tours, Tours, France.
¹² Centre Hospitalier Universitaire de Marseille, Marseille, France.
¹³ University Hospital Split, Split, Croatia.
¹⁴ School of Medicine, University of Split, Split, Croatia.
¹⁵ Faculty for Dental Care and Health, Osijek, Croatia.
¹⁶ University Health Center Osijek, Osijek, Croatia.
¹⁷ Unit for Child and Adolescent Psychiatry, Osijek, Croatia.
¹⁸ IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
¹⁹ DISM, ULSS 16, SOPROXI Onlus, Padua, Italy.
²⁰ Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.
²¹ Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK.
²² HealthTracker Ltd, Kent, UK.
²³ Warwick Medical School, University of Warwick, Coventry, UK.
²⁴ Department of Neurosciences, Centre for Clinical Psychiatry, KU Leuven, Leuven, Belgium.
²⁵ Lille Neurosciences and Cognitions, Plasticity and Subjectivity Team, CURE Platform, Université de Lille, INSERM (U-1172), Fontan Hospital, CHU Lille, Lille, France.
²⁶ CH Versailles, Versailles, France.
²⁷ Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
²⁸ Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France.
²⁹ School of Medicine & Medical Science, University College Dublin, Dublin, Republic of Ireland.
³⁰ Lucena CAMHS, SJOG, Dublin, Republic of Ireland.
³¹ Child and Adolescent Neuropsychiatry Unit, ASST Monza, Monza, Italy.
³² Università Degli Studi Milano Bicocca, Milan, Italy.
³³ Centre Hospitalier Universitaire de Lille, Lille, France.
³⁴ Coventry and Warwickshire Partnership NHS Trust, Coventry, UK.
³⁵ INSERM, CESP U1018, PsyDev, University Paris Saclay, UVSQ, Versailles, France.
³⁶ Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy.
³⁷ Department of Mental Health, Psychiatry Unit, San Gerardo Hospital, Monza, Monza Brianza, Italy.
³⁸ Department of Neurosciences, KU Leuven, Leuven, Belgium.
³⁹ Child and Youth Studies, Campus Social School, University Colleges Leuven Limburg, Heverlee, Belgium.
⁴⁰ Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.
⁴¹ Josefinum Augsburg, Klinik für Kinder- und Jugenspsychiatrie und Psychotherapie, Augsburg, Germany.
⁴² Department of Mental Health, ULSS 6 Euganea, Padua, Italy.
⁴³ SOPROXI Onlus, Padua, Italy.
⁴⁴ Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier de Versailles, Versailles, France.
⁴⁵ Child and Adolescent Neuropsychiatry Unit, AUSL Modena, Modena, Italy.
⁴⁶ Child and Adolescent Neuropsychiatry, Department of Mental Health, Modena, Italy.
⁴⁷ Abteilung für Psychiatrie und Psychotherapie des Kindes-und Jugendalters Weissenau, ZfP Südwürttemberg, Ravensburg, Germany.

^# Contributed equally.

PMID: 35146551
PMCID: PMC9042957
DOI: 10.1007/s00127-022-02238-6

Abstract

Purpose: The service configuration with distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) may be a barrier to continuity of care. Because of a lack of transition policy, CAMHS clinicians have to decide whether and when a young person should transition to AMHS. This study describes which characteristics are associated with the clinicians' advice to continue treatment at AMHS.

Methods: Demographic, family, clinical, treatment, and service-use characteristics of the MILESTONE cohort of 763 young people from 39 CAMHS in Europe were assessed using multi-informant and standardized assessment tools. Logistic mixed models were fitted to assess the relationship between these characteristics and clinicians' transition recommendations.

Results: Young people with higher clinician-rated severity of psychopathology scores, with self- and parent-reported need for ongoing treatment, with lower everyday functional skills and without self-reported psychotic experiences were more likely to be recommended to continue treatment. Among those who had been recommended to continue treatment, young people who used psychotropic medication, who had been in CAMHS for more than a year, and for whom appropriate AMHS were available were more likely to be recommended to continue treatment at AMHS. Young people whose parents indicated a need for ongoing treatment were more likely to be recommended to stay in CAMHS.

Conclusion: Although the decision regarding continuity of treatment was mostly determined by a small set of clinical characteristics, the recommendation to continue treatment at AMHS was mostly affected by service-use related characteristics, such as the availability of appropriate services.

Keywords: Adult mental health services; Child and adolescent mental health services; Transition; Young adults.

PubMed Disclaimer

Conflict of interest statement

The MILESTONE project was funded by EU FP7 programme under grant number 602442. SPS is part-funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care West Midlands (NIHR CLAHRC WM), now recommissioned as NIHR Applied Research Collaboration West Midlands. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. PS is the co-inventor of the HealthTrackerTM and is the Chief Executive Officer and shareholder in HealthTracker Ltd. FF is a Chief Technical Officer and AK is the Chief Finance Officer employed by HealthTracker Ltd, respectively. FCV publishes the Dutch translations of ASEBA, from which he receives remuneration. AM was a speaker and advisor for Neurim, Shire, Infectopharm, and Lilly (all not related to transition research).

Figures

**Fig. 1**
CONSORT flow diagram of participants

See this image and copyright information in PMC

References

1. Singh SP. Transition of care from child to adult mental health services: the great divide. Curr Opin Psychiatry. 2009;22(4):386–390. doi: 10.1097/YCO.0b013e32832c9221. - DOI - PubMed
1. McGorry PD. The specialist youth mental health model: strengthening the weakest link in the public mental health system. Med J Aust. 2007;187(7 Suppl):S53–56. - PubMed
1. Memarzia J, St Clair MC, Owens M, Goodyer IM, Dunn VJ. Adolescents leaving mental health or social care services: predictors of mental health and psychosocial outcomes one year later. BMC Health Serv Res. 2015;15:185. doi: 10.1186/s12913-015-0853-9. - DOI - PMC - PubMed
1. McNicholas F, Adamson M, McNamara N, Gavin B, Paul M, Ford T, Barry S, Dooley B, Coyne I, Cullen W, Singh SP. Who is in the transition gap? Transition from CAMHS to AMHS in the Republic of Ireland. Ir J Psychol Med. 2015;32(1):61–69. doi: 10.1017/ipm.2015.2. - DOI - PubMed
1. Islam Z, Ford T, Kramer T, Paul M, Parsons H, Harley K, Weaver T, McLaren S, Singh SP. Mind how you cross the gap! Outcomes for young people who failed to make the transition from child to adult services: the TRACK study. BJPsych Bull. 2016;40(3):142–148. doi: 10.1192/pb.bp.115.050690. - DOI - PMC - PubMed

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Demographic, clinical, and service-use characteristics related to the clinician's recommendation to transition from child to adult mental health services

Collaborators

Affiliations

Demographic, clinical, and service-use characteristics related to the clinician's recommendation to transition from child to adult mental health services

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical