From Child and Adolescent to Adult Mental Health Services: The Intrepid Journey

Abstract

Background

The move from Child and Adolescent Mental Health Services (CAMHS) to adults’ services (AMHS) is likely to coincide with other transitions in the adolescents’ life. Barriers affecting this transition have been referred in most countries, but there is a lack of studies on this matter.

Aims

To evaluate the transitional process from CAMHS to AMHS in Portugal, focusing on four criteria: continuity of care, parallel care, a transition planning meeting and information transference. The continuity/discontinuity of the diagnosis and therapeutic plan made at CAMHS has also evaluated.

Methods

Identification from a sample of adolescents transferred from Clínica da Juventude (adolescents’ clinic) to 3 major AMHS, collecting information regarding the quality of the transition between these services.

Results

Fifty-nine adolescents were discharged in 2014, average of 16.5 years old, after being followed in our clinic for an average of 7.44 months. Ten continued being followed in adult psychiatric services (17.5%), with different disorders: 4 depressive, 2 personality, 1 anxiety, 1 bipolar, 1 addiction to psychoactive substances, and 1 oppositional defiant disorder. Even in those cases the transition was far from optimal, with 4 of those presenting the need to use adult emergency facilities.

Conclusions

Several barriers between CAMHS and AMHS might account for the ongoing problem with the transition between services. In addition, considering that the onset of severe and recurring mental disorders begins generally before the age of 25, this raises the discussion around the present distinction between child and adolescent mental health services and adult services at 18 years old.

Disclosure of interest

The authors have not supplied their declaration of competing interest.