PMH35 - Clinical Study of the Transition from Pediatric to Adult Mental Health Services in Madrid (Spain)

Abstract

Some of the most serious and chronic psychiatric disorders have its onset in adolescence or before age 25. This study aimed to assess the process of transition from pediatric to adult services in 7 big Hospitals in Madrid (Spain), a region with 6.5 million inhabitants. It explored the experience in users, carers and professionals, to evaluate if clinical pathways should be reviewed. We planned to identify a cohort who have reached the age of 18 -or over- in an 18 month period, and have received treatment at a child and adolescent Mental Unit. Data were collected retrospectively at four time points: last visit at Paediatric, and three times after transition to Adult Mental Health Services. A specific questionnaire about the process for patients, caregivers and mental health professionals was utilized. It was to assess how the process of transition took place, and their opinions on better strategies and tools. Based on previous studies and experiences, the anticipated sample size was around 150 subjects. Pre-identified variables for the study were socio-demographic and clinical, i.e. main and secondary diagnosis, substance abuse, prescribed treatments, family’s social situation (including possible social worker interventions); emergency room visits two years before and six months after transition. The Study started in May 2017. With the cohort bigger than expected (n=734), data completion is expected for May 2018. Preliminary analysis of a group equivalent to predicted sample size showed that 67 % of the patients dropped-out just before transition without a medical discharge, or were transferred to Adult Units but did not attend the first visit. Studies on real world evidence are very useful not only for treatments, but also for clinical procedures. Avoiding drop-out of care during transition to Adult Units seems to be needed in order to improve youth mental health care.