Hill Adam, Wilde Sarah, Tickle Anna
Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.
School of Psychology, College of Social Science, University of Lincoln, Lincoln, UK.
Child Adolesc Ment Health. 2019 Nov;24(4):295-306. doi: 10.1111/camh.12339. Epub 2019 Jun 4.
Transition between Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) can be stressful for the young person and family alike. Previous reviews have focused on specific aspects of transition or perspectives of young people, or have not used systematic approaches to data identification and analysis. The objective of this review was to develop the understanding of the transition between CAMHS and AMHS by systematically identifying and synthesising evidence regarding professionals' and parents/carers' perspectives.
A systematic search in July 2018 was conducted on Medline, PsycINFO and CINAHL. Google Scholar and references of selected articles were also searched. Papers were included if they presented empirical qualitative research in peer-reviewed journals with a primary focus on experiences of parents/carers and/or mental health professionals in relation to adolescents making the CAMHS-AMHS transition. Data were extracted from each full-text paper. The quality of included studies was appraised using an expanded Critical Appraisal Skills Programme (2018) tool, and studies' results were synthesised using meta-ethnography.
Fourteen studies of variable quality were identified. Four main third-order constructs were developed through synthesis: (a) Service cultures; (b) Service resources and gaps; (c) Working relationships between the services; and (d) Leaving secure relationships for new ones.
Professionals and parents experience adolescents' transition from nurturing and comprehensive CAMHS to more individualistic AMHS as having many barriers. There is desire for better preparation for transition between services and relationships, more joint working and better CAMHS-AMHS communication. AMHS service gaps exist, for example for those with neurodevelopmental conditions.
儿童及青少年心理健康服务（CAMHS）与成人心理健康服务（AMHS）之间的过渡，对年轻人及其家庭而言都可能压力重重。以往的综述聚焦于过渡的特定方面或年轻人的观点，或者未采用系统的方法来识别和分析数据。本综述的目的是通过系统地识别和综合有关专业人员以及父母/照料者观点的证据，增进对CAMHS与AMHS之间过渡的理解。
2018年7月在Medline、PsycINFO和CINAHL数据库进行了系统检索。还检索了谷歌学术以及所选文章的参考文献。如果论文发表在同行评审期刊上，且主要关注父母/照料者和/或心理健康专业人员在青少年从CAMHS过渡到AMHS方面的经验，则纳入该论文。从每篇全文论文中提取数据。使用扩展的批判性评估技能计划（2018）工具对纳入研究的质量进行评估，并使用元民族志方法综合研究结果。
共识别出14项质量参差不齐的研究。通过综合分析得出了四个主要的三阶结构：（a）服务文化；（b）服务资源与差距；（c）服务之间的工作关系；（d）离开稳固关系建立新关系。
专业人员和父母都认为，青少年从提供关爱和全面服务的CAMHS过渡到更注重个体化的AMHS存在诸多障碍。人们期望在服务和关系过渡方面有更好的准备、更多的联合协作以及更好的CAMHS与AMHS之间的沟通。AMHS存在服务差距，例如针对患有神经发育障碍的人群。
