Department of Psychology, School of Law, Social and Behavioural Sciences, Kingston University, Kingston Upon Thames, London, Surrey, KT1 2EE, UK.
University College London, Gower Street, London, WC1E 6BT, UK.
Adm Policy Ment Health. 2021 Nov;48(6):1089-1104. doi: 10.1007/s10488-021-01115-9. Epub 2021 Feb 24.
Young people moving from child and adolescent secure hospitals present with complex needs and vulnerabilities and are more likely to experience poor transition outcomes. Previous research has indicated the presence of several risk factors in periods of transition, such as poor liaison among services, lack of proper planning, shortage of beds in adult services, multiple transitions and lack of emotional readiness. However, little evidence exists about the processes and outcomes of transitions from adolescent secure services to adult settings. This study aims to bridge the gap in the existing literature by exploring the views and experiences of key professionals involved in the transition process from six adolescent medium secure units to nine adult secure and community services in England. Thirty-four key workers from 15 child and adolescent (N = 21) and adult (N = 13) forensic hospitals were interviewed to provide information about potential barriers and facilitators to transitions. Face-to-face semi-structured interviews were conducted between January 2016 and December 2017. Thematic analysis was used to identify challenges and facilitators to transitions. Three primary themes were identified: (1) transition processes and preparation; (2) transition barriers and challenges; (3) success factors to transition. Key differences in adult and adolescent service care-models and lack of emotional and developmental readiness to moving onto adult-oriented settings constitute major barriers to positive transition outcomes. Practice and policy implications are considered to address the need for service transformations.
年轻人从儿童和青少年安全医院转移出来，会呈现出复杂的需求和脆弱性，更有可能出现不良的过渡结果。之前的研究表明，在过渡期间存在几个风险因素，如服务之间的联系不畅、缺乏适当的规划、成人服务床位短缺、多次过渡和缺乏情感准备。然而，关于从青少年安全服务过渡到成人环境的过程和结果的证据很少。本研究旨在通过探索英格兰六家青少年中度安全单位向九家成人安全和社区服务机构过渡过程中关键专业人员的观点和经验来填补现有文献的空白。从 15 家儿童和青少年（N=21）和成人（N=13）法医医院采访了 34 名关键工作人员，以提供有关过渡的潜在障碍和促进因素的信息。2016 年 1 月至 2017 年 12 月期间进行了面对面的半结构化访谈。采用主题分析来确定过渡的挑战和促进因素。确定了三个主要主题：（1）过渡过程和准备；（2）过渡障碍和挑战；（3）过渡成功因素。成人和青少年服务模式的主要差异以及缺乏情感和发展准备以适应成人导向的环境，构成了积极过渡结果的主要障碍。考虑到实践和政策影响，以满足服务转型的需要。
