Evaluating the Impact of COVID-19 on the Transition From CAMHS to AMHS in ABUHB – a Retrospective Study

Abstract

Aims

To evaluate the transitions of Aneurin Bevan University Health Board (ABUHB) Child and Adolescent Mental Health Service (CAMHS) patients to Adult Mental Health Services (AMHS) during the COVID-19 pandemic, against regional Health Board policy standards.

Methods

Following a review of the current ABUHB transitions policy and a focused review of the literature, relevant standards were elicited. Retrospective data of transition cases between April 2020 and March 2021 were collected using a standardised data-capture tool from CAMHS records using the EPEX system; cases were anonymised. A questionnaire was constructed and distributed by email to ABUHB CAMHS clinicians to gain further qualitative data.

Results

A total of 34 patients were identified as CAMHS transition cases. 3 were identified as having a transitions co-ordinator, 6 had no record of AMHS having been informed with only 1 case documenting liaison with AMHS at the 6 month mark. 20 cases showed evidence of good patient support before and after transition, and 25 showed young person involvement in decision making. 28/34 cases showed evidence of good coordination of MDTs (multi-disciplinary teams).

There were 16 responses to the staff survey. 93% of respondents were aware of the transition policy, and 68.8% of clinicians strongly agreed/agreed with “I involve young people in their decision making process”. 25% of respondents strongly disagree/disagree when asked whether they work in collaboration with the AMHS. For “I believe my patients are ready to transition at the age of 18” 37.5% remained neutral.

Conclusion

Several of the standards outlined in the ABUHB transition policy are not being met. These include: naming a transition coordinator, informing AMHS 6 months prior to the patient turning 18, and involving the young person in the decision of transfer of care. COVID-19 has evidently impacted the transition process, but more audits must be conducted in order to compare these data to pre-pandemic times.