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. 2023 Oct;26(1):e300814.
doi: 10.1136/bmjment-2023-300814.

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

Rebecca Appleton  1 , Alastair Canaway  2 , Helena Tuomainen  2 , Gwen Dieleman  3 , Suzanne Gerritsen  3 , Mathilde Overbeek  4   5   6 , Athanasios Maras  4   5 , Larissa van Bodegom  4 , Tomislav Franić  7 , Giovanni de Girolamo  8 , Jason Madan  2 , Fiona McNicholas  9   10 , Diane Purper-Ouakil  11   12 , Ulrike M E Schulze  13   14 , Sabine Tremmery  15 , Swaran P Singh  2   16
Affiliations

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

Rebecca Appleton et al. BMJ Ment Health. 2023 Oct.

Abstract

Background: Young 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.

Objective: To conduct a secondary data analysis exploring predictors of transitioning or falling through the gap and associated costs.

Methods: Data 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.

Findings: Young 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.

Conclusions: Total 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 implications: It 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.

Keywords: child & adolescent psychiatry.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
A graph showing the mean total costs over time for each service use variable. For figure 1(D), the high figure for those who transitioned at T3 is skewed by a small number of participants who reported high costs. A&E, Accident and Emergency; FTG, fell through the gap; GP, general practitioner.
See this image and copyright information in PMC

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