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1. Effect of managed transition on mental health outcomes for young people at the child-adult mental health service boundary:A randomised clinical trial

Author

Singh, S. P., Tuomainen, H., Bouliotis, G., Canaway, A., De Girolamo, G., Dieleman, G. C., Franić, T., Madan, J., Maras, A., McNicholas, F., Paul, M., Purper-Ouakil, D., Santosh, P., Schulze, U. M.E., Street, C., Tremmery, S., Verhulst, F. C., Wells, P., Wolke, D., Warwick, J., Tah, Priya, Griffin, James, Appleton, Rebecca, Heaney, Natalie, Lievesley, Kate, Mastroianni, Mathilde, Singh, Jatinder, Adams, Laura, Signorini, Giulia, Ferrari, Alessandro, Gheza, Elisa, Ferrari, Cecilia, Rivolta, Laura, Levi, Flavia, Cataldo, Maria, Manenti, Lidia, Morini, Giorgia, Pastore, Adriana, Stagni, Pamela, Toselli, Cecilia, Varvara, Pamela, Russet, Frédérick, Maurice, Virginie, Humbertclaude, Véronique, Bodegom, Larissa S.Van, Overbeek, Mathilde M., Gerritsen, Suzanne E., Saam, Melanie, Breuninger, Ulrike, Hendrickx, Gaëlle, Singh, S. P., Tuomainen, H., Bouliotis, G., Canaway, A., De Girolamo, G., Dieleman, G. C., Franić, T., Madan, J., Maras, A., McNicholas, F., Paul, M., Purper-Ouakil, D., Santosh, P., Schulze, U. M.E., Street, C., Tremmery, S., Verhulst, F. C., Wells, P., Wolke, D., Warwick, J., Tah, Priya, Griffin, James, Appleton, Rebecca, Heaney, Natalie, Lievesley, Kate, Mastroianni, Mathilde, Singh, Jatinder, Adams, Laura, Signorini, Giulia, Ferrari, Alessandro, Gheza, Elisa, Ferrari, Cecilia, Rivolta, Laura, Levi, Flavia, Cataldo, Maria, Manenti, Lidia, Morini, Giorgia, Pastore, Adriana, Stagni, Pamela, Toselli, Cecilia, Varvara, Pamela, Russet, Frédérick, Maurice, Virginie, Humbertclaude, Véronique, Bodegom, Larissa S.Van, Overbeek, Mathilde M., Gerritsen, Suzanne E., Saam, Melanie, Breuninger, Ulrike, and Hendrickx, Gaëlle

Abstract

Background Poor transition planning contributes to discontinuity of care at the child-adult mental health service boundary (SB), adversely affecting mental health outcomes in young people (YP). The aim of the study was to determine whether managed transition (MT) improves mental health outcomes of YP reaching the child/adolescent mental health service (CAMHS) boundary compared with usual care (UC). Methods A two-arm cluster-randomised trial (ISRCTN83240263 and NCT03013595) with clusters allocated 1:2 between MT and UC. Recruitment took place in 40 CAMHS (eight European countries) between October 2015 and December 2016.

Published
2023

2. Cohort profile

Author

Gerritsen, Suzanne E., Maras, Athanasios, van Bodegom, Larissa S., Overbeek, Mathilde M., Verhulst, Frank C., Wolke, Dieter, Appleton, Rebecca, Bertani, Angelo, Cataldo, Maria G., Conti, Patrizia, Da Fonseca, David, Davidović, Nikolina, Dodig-Ćurković, Katarina, Ferrari, Cecilia, Fiori, Federico, Franić, Tomislav, Gatherer, Charlotte, De Girolamo, Giovanni, Heaney, Natalie, Hendrickx, Gaëlle, Kolozsvari, Alfred, Levi, Flavia Micol, Lievesley, Kate, Madan, Jason, Martinelli, Ottaviano, Mastroianni, Mathilde, Maurice, Virginie, McNicholas, Fiona, O'Hara, Lesley, Paul, Moli, Purper-Ouakil, Diane, de Roeck, Veronique, Russet, Frédérick, Saam, Melanie C., Sagar-Ouriaghli, Ilyas, Santosh, Paramala J., Sartor, Anne, Schandrin, Aurélie, Schulze, Ulrike M. E., Signorini, Giulia, Singh, Swaran P., Singh, Jatinder, Street, Cathy, Tah, Priya, Tanase, Elena, Tremmery, Sabine, Tuffrey, Amanda, Tuomainen, Helena, van Amelsvoort, Therese A. M. J., Wilson, Anna, Walker, Leanne, Dieleman, Gwen C., Adams, Laura, Allibrio, Giovanni, Armando, Marco, Aslan, Sonja, Baccanelli, Nadia, Balaudo, Monica, Bergamo, Fabia, Berriman, Jo, Rethore, Chrystèle Bodier, Bonnet-Brilhault, Frédérique, Boon, Albert, Braamse, Karen, Breuninger, Ulrike, Buttiglione, Maura, Buttle, Sarah, Cammarano, Marco, Canaway, Alastair, Cantini, Fortunata, Cappellari, Cristiano, Carenini, Marta, Carrà, Giuseppe, Charvin, Isabelle, Chianura, Krizia, Coleman, Philippa, Colonna, Annalisa, Conese, Patrizia, Costanzo, Raffaella, Daffern, Claire, Danckaerts, Marina, Giacomo, Andrea de, Dineen, Peter, Ermans, Jean-Pierre, Farmer, Alan, Fegert, Jörg M., Ferrari, Alessandro, Ferrari, Sabrina, Galea, Giuliana, Gatta, Michela, Gheza, Elisa, Goglia, Giacomo, Grandetto, MariaRosa, Griffin, James, Healy, Elaine, Holmes, Keith, Humbertclaude, Véronique, Ingravallo, Nicola, Invernizzi, Roberta, Jardri, Renaud, Keeley, Helen, Kelly, Caoimhe, Killilea, Meghan, Kirwan, James, Klockaerts, Catherine, Kovač, Vlatka, Lida-Pulik, Hélène, Liew, Ashley, Lippens, Christel, Lynch, Fionnuala, Macchi, Francesca, Manenti, Lidia, Margari, Francesco, Margari, Lucia, Martinelli, Paola, McDonald, James, McFadden, Leighton, Menghini, Deny, Migone, Maria, Miller, Sarah, Monzani, Emiliano, Morini, Giorgia, Mutafov, Todor, Nacinovich, Renata, Negrinotti, Cristina, Nelis, Emmanuel, Neri, Francesca, Nikolova, Paulina, Nossa, Marzia, Noterdaeme, Michele, Operto, Francesca, Panaro, Vittoria, Parenti, Aesa, Pastore, Adriana, Pemmaraju, Vinuthna, Pepermans, Ann, Petruzzelli, Maria Giuseppina, Presicci, Anna, Prigent, Catherine, Rinaldi, Francesco, Riva, Erika, Rivolta, Laura, Roekens, Anne, Rogers, Ben, Ronzini, Pablo, Sakar, Vehbi, Salvetti, Selena, Sandhu, Tanveer, Schepker, Renate, Scocco, Paolo, Siviero, Marco, Slowik, Michael, Smyth, Courtney, Spadone, Maria Antonietta, Speranza, Mario, Stagi, Paolo, Stagni, Pamela, Starace, Fabrizio, Stoppa, Patrizia, Tansini, Lucia, Toselli, Cecilia, Trabucchi, Guido, Tubito, Maria, Dam, Arno van, Gutschoven, Hanne Van, West, Dirk van, Vanni, Fabio, Vannicola, Chiara, Varuzza, Cristiana, Varvara, Pamela, Ventura, Patrizia, Vicari, Stefano, Vicini, Stefania, Bentzel, Carolin von, Wells, Philip, Williams, Beata, Zabarella, Marina, Zamboni, Anna, Zanetti, Edda, RS: MHeNs - R2 - Mental Health, Psychiatrie & Neuropsychologie, MUMC+: MA Med Staf Spec Psychiatrie (9), Child and Adolescent Psychiatry / Psychology, Clinical Child and Family Studies, LEARN! - Child rearing, and APH - Mental Health

Subjects
Adult, Internationality, SAMPLE, RJ, child & adolescent psychiatry, ADOLESCENT, Jugendpsychiatrie, Cohort Studies, SDG 3 - Good Health and Well-being, ddc:150, QUALITY-OF-LIFE, Psychiatrische Versorgung, Child psychiatry, Humans, Prospective Studies, SCALE, Demography, Retrospective Studies, Psychiatry, Internationalität, OUTCOMES, DDC 150 / Psychology, Adolescent psychiatry, international health services, General Medicine, WHOQOL-BREF, Europe, Mental Health, Mental health services, CROSS, Adolescent Health Services, EXPERIENCE, Kinderpsychiatrie, adult psychiatry, RA, TRANSITION, RC
Abstract

PurposeThe presence of distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) impacts continuity of mental health treatment for young people. However, we do not know the extent of discontinuity of care in Europe nor the effects of discontinuity on the mental health of young people. Current research is limited, as the majority of existing studies are retrospective, based on small samples or used non-standardised information from medical records. The MILESTONE prospective cohort study aims to examine associations between service use, mental health and other outcomes over 24 months, using information from self, parent and clinician reports.ParticipantsSeven hundred sixty-three young people from 39 CAMHS in 8 European countries, their parents and CAMHS clinicians who completed interviews and online questionnaires and were followed up for 2 years after reaching the upper age limit of the CAMHS they receive treatment at.Findings to dateThis cohort profile describes the baseline characteristics of the MILESTONE cohort. The mental health of young people reaching the upper age limit of their CAMHS varied greatly in type and severity: 32.8% of young people reported clinical levels of self-reported problems and 18.6% were rated to be ‘markedly ill’, ‘severely ill’ or ‘among the most extremely ill’ by their clinician. Fifty-seven per cent of young people reported psychotropic medication use in the previous half year.Future plansAnalysis of longitudinal data from the MILESTONE cohort will be used to assess relationships between the demographic and clinical characteristics of young people reaching the upper age limit of their CAMHS and the type of care the young person uses over the next 2 years, such as whether the young person transitions to AMHS. At 2 years follow-up, the mental health outcomes of young people following different care pathways will be compared.Trial registration numberNCT03013595., publishedVersion

Published
2021
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3. Effect of managed transition on mental health outcomes for young people at the child–adult mental health service boundary : a randomised clinical trial

Author

Singh, S. P., Tuomainen, H., Bouliotis, G., Canaway, A., De Girolamo, G., Dieleman, G. C., Franić, T., Madan, J., Maras, A., McNicholas, F., Paul, M., Purper-Ouakil, D., Santosh, P., Schulze, U. M.E., Street, C., Tremmery, S., Verhulst, F. C., Wells, P., Wolke, D., Warwick, J., Tah, Priya, Griffin, James, Appleton, Rebecca, Heaney, Natalie, Lievesley, Kate, Mastroianni, Mathilde, Singh, Jatinder, Adams, Laura, Signorini, Giulia, Ferrari, Alessandro, Gheza, Elisa, Ferrari, Cecilia, Rivolta, Laura, Levi, Flavia, Cataldo, Maria, Manenti, Lidia, Morini, Giorgia, Pastore, Adriana, Stagni, Pamela, Toselli, Cecilia, Varvara, Pamela, Russet, Frédérick, Maurice, Virginie, Humbertclaude, Véronique, Bodegom, Larissa S.Van, Overbeek, Mathilde M., Gerritsen, Suzanne E., Saam, Melanie, Breuninger, Ulrike, Hendrickx, Gaëlle, The MILESTONE Consortium, and Child and Adolescent Psychiatry / Psychology

Subjects
Clinical trial, Psychiatry and Mental health, medicine.medical_specialty, SDG 3 - Good Health and Well-being, RJ, medicine, Psychiatry, Psychology, Mental health, Applied Psychology, Boundary (real estate), Mental health service
Abstract

BackgroundPoor transition planning contributes to discontinuity of care at the child–adult mental health service boundary (SB), adversely affecting mental health outcomes in young people (YP). The aim of the study was to determine whether managed transition (MT) improves mental health outcomes of YP reaching the child/adolescent mental health service (CAMHS) boundary compared with usual care (UC).MethodsA two-arm cluster-randomised trial (ISRCTN83240263 and NCT03013595) with clusters allocated 1:2 between MT and UC. Recruitment took place in 40 CAMHS (eight European countries) between October 2015 and December 2016. Eligible participants were CAMHS service users who were receiving treatment or had a diagnosed mental disorder, had an IQ ⩾ 70 and were within 1 year of reaching the SB. MT was a multi-component intervention that included CAMHS training, systematic identification of YP approaching SB, a structured assessment (Transition Readiness and Appropriateness Measure) and sharing of information between CAMHS and adult mental health services. The primary outcome was HoNOSCA (Health of the Nation Outcome Scale for Children and Adolescents) score 15-months post-entry to the trial.ResultsThe mean difference in HoNOSCA scores between the MT and UC arms at 15 months was −1.11 points (95% confidence interval −2.07 to −0.14, p = 0.03). The cost of delivering the intervention was relatively modest (€17–€65 per service user).ConclusionsMT led to improved mental health of YP after the SB but the magnitude of the effect was small. The intervention can be implemented at low cost and form part of planned and purposeful transitional care.

Published
2021

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