The effect of organisational resources and eligibility issues on transition from child and adolescent to adult mental health services

Ruth Belling; Susan McLaren; Moli Paul; Tamsin Ford; Tami Kramer; Tim Weaver; Kimberly Hovish; Zoebia Islam; Sarah White; Swaran P Singh

doi:10.1177/1355819614527439

The effect of organisational resources and eligibility issues on transition from child and adolescent to adult mental health services

J Health Serv Res Policy. 2014 Jul;19(3):169-176. doi: 10.1177/1355819614527439. Epub 2014 Apr 3.

Authors

Ruth Belling¹, Susan McLaren², Moli Paul³, Tamsin Ford⁴, Tami Kramer⁵, Tim Weaver⁶, Kimberly Hovish⁷, Zoebia Islam⁸, Sarah White⁹, Swaran P Singh¹⁰

Affiliations

¹ Research and Evaluation Consultant, Evaluation Works, Bedford, UK.
² Emeritus Professor, Faculty of Health and Social Care, London South Bank University, London, UK mclaresm@lsbu.ac.uk.
³ Principal Teaching Fellow, Division of Mental Health and Well Being, Warwick Medical School, University of Warwick, UK.
⁴ Professor of Child and Adolescent Psychiatry, University of Exeter Medical School, University of Exeter, UK.
⁵ Senior Clinical Research Fellow/Consultant in Child and Adolescent Psychiatry, Faculty of Medicine, Imperial College London, UK.
⁶ Senior Lecturer in Mental Health Services Research, Faculty of Medicine, Imperial College London, UK.
⁷ Research Officer, Department of Childhood, Families and Health, Institute of Education, University of London, UK.
⁸ Senior Research Fellow/Lecturer, LOROS Hospice Care for Leicester, Leicestershire and Rutland and Birmingham and Solihull Mental Health Foundation Trust, UK.
⁹ Biostatistician, Section of Mental Health, Division of Population Health Sciences and Education, St. George's, University of London, UK.
¹⁰ Professor/Head of Division of Mental Health and Well Being, Warwick Medical School, University of Warwick, UK.

PMID: 24700210
DOI: 10.1177/1355819614527439

Abstract

Objectives: To investigate the organisational factors that impede or facilitate transition of young people from child and adolescent (CAMHS) to adult mental health services (AMHS).

Methods: Thirty-four semi-structured interviews were conducted with health and social care professionals working in child and adult services in four English NHS Mental Health Trusts and voluntary organisations. Data were analysed thematically using a structured framework.

Results: Findings revealed a lack of clarity on service availability and the operation of different eligibility criteria between child and adult mental health services, with variable service provision for young people with attention deficit hyperactivity disorder, autism spectrum disorders and learning disabilities. High workloads and staff shortages were perceived to influence service thresholds and eligibility criteria.

Conclusions: A mutual lack of understanding of services and structures together with restrictive eligibility criteria exacerbated by perceived lack of resources can impact negatively on the transition between CAMHS and AMHS, disrupting continuity of care for young people.

Keywords: resources; transition from child/adolescent to adult mental health services.