Abstract
Aims and methodThe Transitions of Care from Child and Adolescent Mental Health Services to Adult Mental Health Services (TRACK) study was a multistage, multicentre study of adolescents' transitions between child and adult mental health services undertaken in England. We conducted a secondary analysis of the TRACK study data to investigate healthcare provision for young people (n = 64) with ongoing mental health needs, who were not transferred from child and adolescent mental health services (CAMHS) to adult mental health services mental health services (AMHS).ResultsThe most common outcomes were discharge to a general practitioner (GP; n = 29) and ongoing care with CAMHS (n = 13), with little indication of use of third-sector organisations. Most of these young people had emotional/neurotic disorders (n = 31, 48.4%) and neurodevelopmental disorders (n = 15, 23.4%).Clinical implicationsGPs and CAMHS are left with the responsibility for the continuing care of young people for whom no adult mental health service could be identified. GPs may not be able to offer the skilled ongoing care that these young people need. Equally, the inability to move them decreases the capacity of CAMHS to respond to new referrals and may leave some young people with only minimal support.
Highlights
Clinical implications general practitioner (GP) and child and adolescent mental health services (CAMHS) are left with the responsibility for the continuing care of young people for whom no adult mental health service could be identified
Of the remaining four young people who were not signposted to other services, two had a diagnosis of emotional and neurotic disorder; their cases were closed by CAMHS and they were discharged to their GP
Previous papers reporting TRACK findings have highlighted that adult mental health services mental health services (AMHS) accepted 93% of referrals they received[18] and that the main reasons for non-referral to AMHS were refusal by adolescents or parents/carers, CAMHS clinicians thinking AMHS would not accept the referral/that AMHS had no appropriate service or that CAMHS were still planning to refer to AMHS.[16]
Summary
This young person had a dual diagnosis of conduct and neurodevelopmental disorders, but no information about further care was recorded. The third open case had a diagnosis of neurodevelopmental disorder, and it was marked as not closed at the time of completion of data collection, there was no record of how long ongoing care had been received at CAMHS after the referral was made. The final pending case was of a person with dual diagnosis of emotional/neurotic and neurodevelopmental disorders This case had not been formally closed by CAMHS, care was not continued and the young person was effectively discharged to their GP.
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