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Report demands improved transition of young people to adult mental health services

Healthcare Safety Investigation Branch says ‘many still do not have a positive experience’

A more flexible model is needed for the transition of young people from child and adolescent mental health services (CAMHS) to adult mental health services, an investigation has found.


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The Healthcare Safety Investigation Branch (HSIB) has published its second and final report on this transition, based on ‘a new learning culture around mistakes in the NHS’.

The first report was commissioned following the suicide of an 17-year-old male who was in the process of being transferred between the two services.

HSIB said an estimated 25,000 young people transition from CAMHS each year, and that ‘research has identified that few of those receive an “ideal” transition’.

A flexible, managed transition

The branch found that young people would benefit from a flexible, managed transition to adult mental health services, which has been carefully planned with the young person, and incorporates a period of shared care as well as follow-up after transition.

Acute and mental health trusts were found to lack standardised tools or methods for transition, said HSIB. It added that structured conversations with young people and their families regarding transition would enable them to ask questions about their diagnosis, needs and treatment.

Poor coordination and communication

Parliamentary and health service ombudsman Rob Behrens said: ‘This report reinforces what we’re seeing in our casework – poor coordination of mental health services, as well as problems in communication with patients and their families.

‘We must maintain momentum in improving mental health services to ensure patients receive the safe, effective care they need, and to prevent the same mistakes happening to others.’

The HSIB’s recommendations include:  

  • NHS England should work with partners to identify and meet the needs of young adults who have mental health problems but do not meet the current criteria for access to adult mental health services.
  • NHS England should require clinical commissioning groups (CCGs) to demonstrate that the budget identified for current children and young people’s services – those delivering care up to the age of 18 – is spent only on this group.
  • The Care Quality Commission should extend the remit of inspections to ensure the whole care pathway is examined.

The HSIB also said clinicians in CAMHS and adult mental health services should be trained in safe and effective transitions.

Disengagement from services

HSIB chief investigator Keith Conradi said: ‘Experts have documented the elements of a safe and effective transition for many years. However, many young people still do not have a positive experience and, as a result, disengage from services.

‘I believe this is an important issue of increasing significance for young people, and I am pleased to publish our second report.’


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