mental health transitions for young people dr yvonne anderson
DESCRIPTION
Mental health transitions for young people: challenges and solutions Dr Yvonne Anderson NHS Improving Quality held an event in London on 31 July 2013 to progress the children and young people transition to adult services work with a focus on turning the rhetoric into practice entitled “Working to Define a Generic Service Specification for Transition”TRANSCRIPT
Mental health transitions for young people: challenges and solutions
Dr Yvonne Anderson
“The transition to adulthood is becoming more complex, longer and more risky. It is a time when young people enter a new and exciting world with new rights – and responsibilities. It is also the time when they take decisions that will affect the rest of their lives.” Social Exclusion Unit ,2005,
Transitions: Young adults with complex needs
Over 10 years of reports and research detailing poor transition
– Track – YoungMinds SOS project – HASCAS Transitions Project – PHF/MHF Right Here– NSFs • Heightened focus from CAMHS
National Advisory Council • Increased awareness of the
significance of transition as a life stage and success of Transition Support Programme
Why do young adults need a different approach?
• Three great transitions: work to school, home to independent living, parented to becoming independent/a parent
• The brain is still changing, especially developing impulse control
• Mental Health in adolescents is deteriorating - and incidence rises from 1:10 in children to 1:6 in adults
• Patterns of service use and access develop early in life, so how young people experience services when they first use them will affect engagement as adults
Majority of serious mental health problems typically commence in
young people
A taxonomy
Severe and enduring MH
Disorders recognised by CAMHS not AMHS
Complex yp without a diagnosis but highly vulnerable
Adult Mental Health Services Transition not guaranteed
ADHD, Mild to moderate LD, ASD Not severe enough
Limited, patchy AMHSYIACs and voluntary sector
Return to primary careVoluntary sector
No service
The cost of not providing accessible services
• School/college/work breaks down • Crisis presentation • Family breakdown• Homelessness
Sources: SEU,2003 2004, Whose Crisis Layard ,2005, Mental health: Britain's biggest social problem?Street, 2007, Pushed into the Shadows
We know what young people want ..
We know what young people want ..
• To be listened to and understood• To be taken seriously• A well planned service where the transition and discharge
arrangements happen smoothly , it shouldn’t be left to us or our families to manage it
• Flexible services focused on developmental age rather than chronological age and on our individual needs
• Choice , information and advice to help us make informed choices about our care and to help us move on
• Honesty about what can and cant be kept confidential• Continuity of care – it take time to build relationships • We shouldn’t have to fight for our rights
What does a good service transition look like?
• Information transfer• Shared working for a period of time • Transition planning – at least one meeting
between CAMHS, AMHS and young person• Continuity – 3 months on maintained contact
with AMHS/appropriate discharge
Singh et al 2010 Track Study
No health without mental health • Whole life course• Explicit referral to
transitions • Outcome iv – young people’s
experience of transitions
“Careful planning of the transfer of care between services will prevent arbitrary discontinuities in care as people reach key transitions. Services can improve transitions, including from child and adolescent mental health services into adult mental health services, or back to primary care, by: • Planning for transition early, listening to young people and
improving their self efficacy; • Providing appropriate and sensible advice so that young
people can exercise choice effectively and participate in decisions about which adult and other services they receive; and
• Focusing on outcomes and improving joint commissioning, to promote flexible services based on developmental needs.” Page 25
Young People's Mental Health Service Transitions project
• Commissioned jointly by DH Adult Mental Health and Children and Families CAMHS Policy Teams
• Collaboration between National Mental Health Development Unit (NMHDU), National CAMHS Support Service (NCSS) and Social Care Institute for excellence (SCIE)
• NCSS/NMHDU products delivered by March 2011
• SCIE products delivered by November 2011• Supported by Virtual Expert Reference Group
Yvonne [email protected]
Author of e-learning (2011), co-producer of MH Transitions self assessment tool (2011), author of HASCAS tools for
transition (2006)
Kathryn [email protected]
National lead for young people’s MH service transitions project (to 2011), author of Stressed out and Struggling
(2006)