Merrick Hannah, King Chris, McConachie Helen, Parr Jeremy R, Le Couteur Ann
Population Health Sciences Institute, Newcastle University, UK.
Northern Regional Child & Adolescent Psychiatry training scheme, UK.
BJPsych Open. 2020 Jun 3;6(4):e58. doi: 10.1192/bjo.2020.41.
Transition from child-centred to adult mental health services has been reported as challenging for young people. It can be especially difficult for young people with autism spectrum disorder (ASD) as they manage the challenges of adolescence and navigate leaving child and adolescent mental health services (CAMHS).
This study examines the predictors of transfer to adult mental health services, and using a qualitative analysis, explores the young people's experiences of transition.
A UK sample of 118 young people aged 14-21 years, with ASD and additional mental health problems, recruited from four National Health Service trusts were followed up every 12 months over 3 years, as they were discharged from CAMHS. Measures of mental health and rich additional contextual information (clinical, family, social, educational) were used to capture their experiences. Regression and framework analyses were used.
Regression analysis showed having an attention-deficit hyperactivity disorder diagnosis and taking medication were predictors of transfer from child to adult mental health services. Several features of young people's transition experience were found to be associated with positive outcomes and ongoing problems, including family factors, education transitions and levels of engagement with services.
The findings show the importance of monitoring and identifying those young people that might be particularly at risk of negative outcomes and crisis presentations. Although some young people were able to successfully manage their mental health following discharge from CAMHS, others reported levels of unmet need and negative experiences of transition.
据报道，从以儿童为中心的心理健康服务过渡到成人心理健康服务对年轻人来说具有挑战性。对于患有自闭症谱系障碍（ASD）的年轻人而言，这可能尤其困难，因为他们要应对青春期的各种挑战，并设法离开儿童和青少年心理健康服务机构（CAMHS）。
本研究考察了转至成人心理健康服务的预测因素，并通过定性分析探索了年轻人的过渡经历。
从四个国民保健服务信托机构招募了118名年龄在14至21岁之间、患有ASD且伴有其他心理健康问题的英国年轻人作为样本，在他们从CAMHS出院后的3年里，每12个月对其进行一次随访。使用心理健康测量方法以及丰富的其他背景信息（临床、家庭、社会、教育方面）来了解他们的经历。采用了回归分析和框架分析。
回归分析表明，患有注意力缺陷多动障碍诊断以及正在服药是从儿童心理健康服务转至成人心理健康服务的预测因素。研究发现，年轻人过渡经历的几个特征与积极结果和持续存在的问题相关，包括家庭因素、教育过渡以及与服务机构的参与程度。
研究结果表明了监测和识别那些可能特别面临负面结果和危机情况风险的年轻人的重要性。尽管一些年轻人在从CAMHS出院后能够成功管理自己的心理健康，但其他人报告了未满足的需求程度以及负面的过渡经历。
