National Institute for Health Research (NIHR) Mental Health Policy Research Unit, Division of Psychiatry, UCL, London.
Department of Languages and Literatures, University of Basel, Switzerland; lecturer in English business communication, Lucerne University of Applied Sciences and Arts, Switzerland.
Br J Gen Pract. 2022 May 26;72(719):e413-e420. doi: 10.3399/BJGP.2021.0678. Print 2022 Jun.
Owing to poor continuity of care between child and adult mental health services, young people are often discharged to their GP when they reach the upper boundary of child and adolescent mental health services (CAMHS). This handover is poorly managed, and GPs can struggle to support young people without input from specialist services. Little is known about young people's experiences of accessing mental health support from their GP after leaving CAMHS.
To explore the experiences and perspectives of young people and the parents/carers of young people receiving primary care support after CAMHS and to identify barriers and facilitators to accessing primary care.
Qualitative study with young people and parents in two English counties: London and West Midlands.
Narrative interviews were conducted with 14 young people and 13 parents who had experienced poor continuity of care after reaching CAMHS transition boundary. Data were analysed using reflexive thematic analysis.
Three themes were identified: unmet mental health needs, disjointed care, and taking responsibility for the young person's mental health care. Barriers included the perception that GPs couldn't prescribe certain medication, anxiety caused by the general practice environment, and having to move to a new practice at university. Young people's positive experiences were more likely to include having a long-term relationship with their GP and finding that their GP made time to understand their needs and experiences.
GPs could help to meet the unmet needs of young people unable to access specialist mental health services after leaving CAMHS. There is a need for comprehensive handover of care from CAMHS to GPs, which could include a joint meeting with the young person and a member of the CAMHS team. Future research should focus on interventions which improve continuity of care for young people after leaving CAMHS, and collaborative working across community mental health services.
由于儿童和成人心理健康服务之间的护理连续性差，年轻人在达到儿童和青少年心理健康服务 (CAMHS) 的上限时通常会被转介给他们的全科医生 (GP)。这种交接管理不善，全科医生在没有专科服务投入的情况下，难以支持年轻人。对于离开 CAMHS 后从全科医生那里获得心理健康支持的年轻人的经历，知之甚少。
探讨年轻人和年轻人的父母/照顾者在离开 CAMHS 后接受初级保健支持的经验和观点，并确定获得初级保健的障碍和促进因素。
在英格兰的两个郡（伦敦和西米德兰兹）进行了一项针对年轻人和父母的定性研究：伦敦和西米德兰兹。
对 14 名年轻人和 13 名经历过 CAMHS 过渡边界后护理连续性差的父母进行了叙述性访谈。使用反思性主题分析对数据进行分析。
确定了三个主题：未满足的心理健康需求、脱节的护理和对年轻人心理健康护理的责任。障碍包括全科医生无法开某些药物的看法、全科医生就诊环境引起的焦虑以及在大学时不得不转到新的诊所。年轻人的积极体验更有可能包括与他们的 GP 建立长期关系，并且发现他们的 GP 有时间了解他们的需求和经验。
全科医生可以帮助满足离开 CAMHS 后无法获得专科心理健康服务的年轻人的未满足需求。需要将护理从 CAMHS 全面转介给全科医生，其中包括与年轻人和 CAMHS 团队成员的联合会议。未来的研究应集中在改善离开 CAMHS 后年轻人的护理连续性的干预措施上，并在社区心理健康服务之间开展合作。
