Abstract
The Royal College of Psychiatrists has published recommendations for managing transitions between child and adolescent mental health services (CAMHS) and adult services for eating disorders. A self-report questionnaire was designed to establish how many CAMHS teams meet these recommendations and was distributed to 70 teams providing eating disorders treatment in England. Of the 38 services that participated, 31 (81.6%) reported a flexible upper age limit for treatment. Only 6 services (15.8%) always transferred young people to a specialist adult eating disorders service and the majority transferred patients to either a specialist service or a community mental health team. Most services complied with recommended provision such as a written transition protocol (52.6%), individualised transition plans (78.9%), joint care with adult services (89.5%) and transition support for the family (73.7%). Services are largely compliant with the recommendations. It is a concern that only a small proportion of services are always able to refer to a specialist adult service and this is likely to be due to a relative lack of investment in adult services.
Highlights
Most services complied with recommended provision such as a written transition protocol (52.6%), individualised transition plans (78.9%), joint care with adult services (89.5%) and transition support for the family (73.7%)
Clinical experience suggests that a significant number of patients whose treatment is not complete when they reach the upper age threshold for child and adolescent mental health services (CAMHS) are unable to access adult eating disorders services; they may instead find themselves being treated in generic adult mental health services or discharged to primary care
It is of note that the majority of services were CEDS-CYP, rather than generic CAMHS, reflecting the recent increase in investment in eating disorder services for this group
Summary
Forty-three out of seventy services (61%) responded (Fig. 1). Five of the services that responded were all-age services and were excluded, giving a total of 38 that were included in the analysis. Six services (15.8%) always transferred young people to a specialist adult eating disorders service. Twenty-eight services (73.7%) reported that some young people went to a specialist eating disorders service and some to a community mental health team. Thirty-four services (89.5%) had a procedure for identifying young people who would be moving from CAMHS to adult services at least 6 months before the planned transition. Thirty-seven services (97.4%) reported that there was a difference in therapeutic model/orientation between themselves and adult services. Twenty-seven services (71.1%) reported that their transition planning addressed changes in the therapeutic model, but six services (15.8%) did not answer this question. One service commented on the big difference in the risk threshold between CAMHS and adult services Another commented that the ‘adult system is based around BMI criteria which not all of our young people fit into’. Twenty-nine (76.3%) reported that they could delay the
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