Psychiatric Bulletin (2005) 29: 436. doi: 10.1192/pb.29.11.436
© 2005 The Royal College of Psychiatrists
Psychiatric Bulletin (2005) 29: 436
© 2005 The Royal College of Psychiatrists
Transfer from child to adult mental health services
Anne Thompson, Consultant in Child and Adolescent Psychiatry
Lincolnshire Partnership NHS Trust, Lincoln LN2 5RT, e-mail:
anne.thompson{at}lpt.nhs.uk
Singh et al (Psychiatric Bulletin, August 2005,
29, 292-294) discuss the risk of disrupted care for young people who
outgrow child and adolescent mental health services (CAMHS).
Lincolnshire Partnership NHS Trust has a protocol for good practice
surrounding transfer of a young persons care from child to adult mental
health services. However, in an audit of these procedures involving 82 young
people aged 17 or 18 years who were discharged from three of our community
CAMHS teams over a 2-year period, only seven were transferred to adult
services. CAMHS clinicians identified 32 other young people who left the
service with unresolved mental health problems: a suitable adult service could
not be found for one young person, 21 young people dropped out of CAMHS and
ten young people did not want to be referred to adult services.
The paucity of psychological therapies in adult mental health services
created difficulties for CAMHS clinicians in finding suitable follow-on
services. Perhaps the prospect of an inevitable ending with no further support
contributed to the high drop-out rate of young people approaching the end of
the service available to them in CAMHS? Some young people clearly said they
did not want to have to start from the beginning in establishing
a therapeutic relationship with a new worker. Others were perhaps influenced
in declining ongoing care by the perceived stigma of adult services.
Our audit findings add to the evidence that the current differing
perspectives of CAMHS and adult mental health services create gaps in services
through which vulnerable young people fall.