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?
As an adolescent or young adult, you may be experiencing substantial changes in many areas of your life, including school, relationships and work. You might, for example, be leaving home to attend college or university or to start another professional training. If, in addition to this, you are living with a mental health problem and you need to move from CAMHS to AMHS, then helping you through this move – making sure that your views are heard as to what help you need, and planning with you which service may be the closest or most appropriate for you to go to – is very important. Understandably, the prospect of transition can seem daunting, especially if you have built up a good relationship with your current mental health team - this is why it is crucial that young people feel supported all the way through such a transition.
Why do we need research about young people and mental health transitions?
Existing research about young people and transition between different mental health services, in particular the move from CAMHS to AMHS, highlights that often young people experience poor or disjointed care. This can lead to some patients falling into a "gap" between services and being left unsupported at a critical time. For these reasons, we need to find out much more about what does work in order to improve the transition for any young people who are moving from CAMHS to AMHS.
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 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.
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.
How young people have been involved in MILESTONE
The MILESTONE researchers recognize that young people who have used CAMHS are the experts regarding the care, support and treatment offered in the transition period and actual transition; understanding young people’s views and experiences is vital in helping the researchers to identify and improve the links between different services.
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 out all data collection tools with our Young Project Advisors to check whether 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 questions or needed to change arrangements 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.