Abstract
BackgroundThe transitioning of young patients from child and adolescent to adult mental health services when indicated often results in the interruption or termination of service. The personal views of young service users on current clinical practice are a valuable contribution that can help to identify service gaps. The purpose of this qualitative study was to explore the perceptions of health care of young people with mental health problems in the transition age range (16–25 years), and to better understand health behaviour, care needs and the reasons for disengaging from care at this point in time.MethodsSeven group discussions and three interviews were conducted with 29 young people in this age range. Discussions were audio-taped, transcribed verbatim and analysed following the reconstructive approach of R. Bohnsack’s documentary method.ResultsAn overarching theme and nine subthemes emerged. Participants displayed a pessimistic and disillusioned general attitude towards professional mental health services. The discussions highlighted an overall concern of a lack of compassion and warmth in care. When they come into contact with the system they often experience a high degree of dependency which contradicts their pursuit of autonomy and self-determination in their current life stage. In the discussions, participants referred to a number of unmet needs regarding care provision and strongly emphasised relationship issues. As a response to their care needs not being met, they described their own health behaviour as predominantly passive, with both an internal and external withdrawal from the system.ConclusionsResearch and clinical practice should focus more on developing needs-oriented and autonomy-supporting care practice. This should include both a shift in staff training towards a focus on communicative skills, and the development of skills training for young patients to strengthen competences in health literacy.
Highlights
The transitioning of young patients from child and adolescent to adult mental health services when indicated often results in the interruption or termination of service
The present paper followed the consolidated criteria for reporting qualitative research (COREQ) checklist [26]
The experience of failing to meet expectations of self-optimisation might have caused frustration and anger towards the mental health services system. These results indicate that integrating the mental illness into their personal identities and lives in terms of a recovery process is a permanent challenge for transition-age youth [29]
Summary
The transitioning of young patients from child and adolescent to adult mental health services when indicated often results in the interruption or termination of service. The personal views of young service users on current clinical practice are a valuable contribution that can help to identify service gaps. The purpose of this qualitative study was to explore the perceptions of health care of young people with mental health problems in the transition age range (16–25 years), and to better understand health behaviour, care needs and the reasons for disengaging from care at this point in time. Young people aged 16–25 with mental health problems have received increasing attention in research and clinical practice as a vulnerable group with special health care needs. A lack of knowledge of where to go for which problems, as well as fewer offers of the low-threshold and less formal services usually preferred by young patients, make it difficult to find the right place to go [7]
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