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The MILESTONE project proposes an EU-wide study of transition from CAMHS to AMHS, to strengthen transitional care across eight different healthcare systems.
We aim to transform services so that current weakness in the care pathway is eradicated and replaced by clinically robust, cost effective, high quality accessible care for vulnerable young people. In a series of high-quality interlinked projects, we will:

  1. Map the CAMHS-AMHS interface across participating sites to determine structural and policy components (including legal differences) of transitional care across the whole of EU (WP1).
  2. Develop, translate and validate web-based and paper versions of Patient Reported Outcome Measures (PROMs) for successful transitions and develop a data capture and monitoring system (WP2).
  3. Develop, translate and validate a Transition Readiness and Appropriateness Measure (TRAM) that identifies high-risk, high-need cases for whom transition to AMHS is critical; and determine threshold criteria for interagency referral and successful multidisciplinary and intersectoral liaison (WP2).
  4. Conduct a cohort study with nested cluster randomised controlled trial (cRCT).
  5. The prospective cohort study (WP4) will delineate the transition journey of a large number of young people across eight EU countries, identify predictors of good and poor transition, and determine long-term outcomes of young people, who cross the transition boundary in relation to mental health, functioning, need for care and service use.
  6. The cRCT will assess the (cost-) effectiveness of implementing the model of managed transition on health and social outcomes in young people leaving CAMHS.
  7. Identify and validate cost and outcome measures for transitional care and conduct a cost-effectiveness evaluation of the trial intervention (WP5).
  8. Explore the ethical challenges of ensuring care delivery to those who need it against the risk of ‘pathologising’ transient and self-limiting disorders of adolescence (WP6).
  9. Develop EU-wide guidelines for optimising transitional care, offering individualised and personalised transitional care while accounting for variations in healthcare systems across EU, and generic and healthcare model-specific recommendations for dissemination to all key stakeholders (WP7).
  10. Develop and implement training packages for key professionals that will improve patient outcomes, experience and satisfaction with care (WP8).
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