What do we mean by transition?
This is a term that is often used to describe the process of moving from one service to another. When we are thinking about mental health services, it is often used to refer to the move between mental health services for children and young people (sometimes called CAMHS – child and adolescent mental health services) and adult mental health services (AMHS). The age at which a young person might make a transition between mental health services varies from country to country; quite often, the transition age boundary is 18 years of age though in some places, transition may happen at 16 or 17.
Why is transition important?
A smooth transition from mental health services for children and young to services for adults is important in terms of ensuring continuity of care, and that young people and their families feel supported and informed as this transition takes place. Often, a particular challenge is that this move coincides with a young person experiencing other crucial changes in their lives – for example, they may be leaving school or going away from home to attend college or university, or to start another professional training. This can make planning their mental health care quite complicated. For a young person and their family, it can also seem daunting, especially if they have built up a good relationship with their current mental health team. This is why it is particularly important to making sure that young people’s views are heard as to the help and support they want and that they are fully involved in planning any transition between services.
Why do we need research about transition in mental health services for children and young people?
The MILESTONE study is unique in that it is a five-year pan-European research project which offers the opportunity to learn from different countries about how they currently support young people in transition, what works well or not. The main focus is young people who need to move on to AMHS because of ongoing mental health problems but alongside this, MILESTONE also aims to identify those young people who can safely be discharged from specialist mental health services.
Existing research about young people and transition between different mental health services, in particular the transition from CAMHS to AMHS, highlights that young people often experience poor or disjointed care. This can lead to some individuals falling into a "gap" between services and being left unsupported at a critical time.
Approval for our research has been granted from different Research Ethics Committees in each of the eight countries involved in MILESTONE. A steering committee and a special board of independent experts - the Scientific Clinical and Ethical Advisory Board (SCEAB) are in place to oversee how the study is being run.
The role of parents, carers or other relatives in the MILESTONE study
As a parent, carer (or partner) of a young person with one or more mental health problems, it is likely that you have been supporting your loved one for some time now, and for this reason, if this young person is approaching the transition phase of their mental health care and treatment, or have already moved on from CAMHS, then you have a unique perspective on how this move went, what worked well, and what should be improved.
Our start point has been to work closely with different CAMHS in the eight partner countries to identify young people approaching the transition phase of care, and then to provide them with detailed information about MILESTONE and the information we hope to collect. At the start of MILESTONE, we were also very careful to test all data collection tools with our Young Project Advisors to check if they made sense and did not take too long to complete.
Any young people expressing interest in taking part in MILESTONE also received information about the different times the research team would need to contact them, and also how to keep in touch with the researchers if they had any inquiries or needed to change an arrangement for completing the MILESTONE research questionnaires.
By the start of this year (2018) over 1,000 young people are taking part in the MILESTONE study providing very valuable information about their mental health and their experiences of transition. Most of the young people have completed the study questionnaires at three time points. The aim is to complete the fourth and final set of follow-up questionnaires by 31 December 2018.