Tonteg Child and Family Centre, Tonteg Hospital, Cwm Taf NHS Trust, Pontypridd, UK.
Curr Opin Psychiatry. 2010 Jul;23(4):311-7. doi: 10.1097/YCO.0b013e32833a51e2.
The importance of ensuring robust arrangements for young people's transitions from specialist child and adolescent mental health services to specialist mental health services for adults is well documented in the international literature. Nonetheless, according to young people, there remains great variation in the quality of services in respect of their transitions. Furthermore, the problems that we report are by no means confined to single continents. This review examines recent literature and explores the themes that emerge from it with a view to finding solutions.
Our findings from the literature suggest a clear strategic direction to improve the quality of the care of young people who need to move from specialist child and adolescent mental health services to specialist mental health services for adults. Our examination of the literature identifies a number of themes that have been recognized by practitioners and we have used them to define a model of care and aspects of good practice. We think they should be included within all evidence-based policies, protocols and care pathways for young people. There is little literature available that documents the personal experiences of young people in transition and their families, but consistent themes emerge from what is available.
There are a number of topics that require active consideration when preparing young people for transition between services. Despite the limited volume of research, and particularly that which has directly involved young people and families, we know from anecdote, experience and local audit and research that improvements in service design and practice are required. These matters inform the solutions that we suggest. We see as pivotal involving young people directly in planning their own care and setting quality standards for healthcare and other services.
目的:确保年轻人从儿童和青少年精神卫生专科服务顺利过渡到成人精神卫生专科服务的相关安排完善,这一点在国际文献中已有充分记载。尽管如此,根据年轻人的反馈,在服务过渡方面,服务质量仍存在很大差异。此外,我们报告的问题绝非仅限于某一特定地区。本综述查阅了最新文献,并对其中出现的主题进行了探讨,以期找到解决方案。
最新发现:我们从文献中发现,为了提高需要从儿童和青少年精神卫生专科服务过渡到成人精神卫生专科服务的年轻人的护理质量,有明确的战略方向可循。我们对文献的研究确定了一些已被从业者认可的主题,我们用这些主题来定义护理模式和良好实践的各个方面。我们认为,这些主题应该包含在所有针对年轻人的循证政策、方案和护理路径中。虽然有一些文献记录了年轻人及其家庭在过渡期间的个人经历,但这些文献数量很少,而且从中提取的主题也比较一致。
总结:在为年轻人做好服务之间的过渡准备时,有许多话题需要认真考虑。尽管研究数量有限,尤其是那些直接涉及年轻人及其家庭的研究数量有限,但我们从轶事、经验以及当地的审计和研究中了解到,需要改进服务设计和实践。这些问题为我们提出的解决方案提供了依据。我们认为,让年轻人直接参与规划自己的护理,并为医疗保健和其他服务设定质量标准至关重要。