The black hole of the transition process: dropout of care before transition age in adolescents

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Reneses Prieto, Blanca and Escudero, Almudena and Tur, Nuria and Agüera Ortiz, Luis and Moreno, Dolores María and Saiz Ruiz, Jerónimo and Rey Bruguera, Mayelin and Pando, María Fuencisla and Bravo Ortiz, Maria Fe and Moreno, Ana and Rey Mejías, Ángel Luis Del and Singh, Swaran P. (2022) The black hole of the transition process: dropout of care before transition age in adolescents. European Child & Adolescent Psychiatry . ISSN 1018-8827

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Official URL: https://doi.org/10.1007/s00787-021-01939-8




Abstract

Recent evidence confirms the risks of discontinuity of care when young people make a transition from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS), although robust data are still sparse. We aimed to identify when and how patients get lost to care during transition by tracking care pathways and identifying factors which influence dropping out of care during transition. This is a retrospective observational study of 760 patients who reached the transition age boundary within 12 months before transition time and being treated at CAMHS for at least during preceding 18 months. Data were collected at two time points: last visit to CAHMS and first visit to AHMS. Socio-demographic, clinical and service utilization variables on CAMHS treatment were collected. In the 12 months leading up to the transition boundary, 46.8% of subjects (n = 356) withdrew from CAHMS without further contact with AHMS, 9.3% withdrew from CAHMS but were referred to AHMS by other services, 29% were transferred from CAHMS to AHMS, 10% remained at CAHMS and 5% patients were transferred to alternative services. Fifty-six percent of subjects experience cessation of care before the transition age. The risk of dropout increases with shorter contact time in CAMHS, is greater in subjects without pharmacological treatment, and decreases in subjects with psychosis, bipolar disorder, eating disorders, mental retardation, and neurodevelopmental disorders. This study confirms that a large number of people drop out of care as they approach the CAMHS transition and experience discontinuity of care during this critical period.


Item Type:Article
Additional Information:

CRUE-CSIC (Acuerdos Transformativos 2022)

Uncontrolled Keywords:Adolescent psychiatry, Patient dropout, Transitional care, Continuity of care, Care pathways
Subjects:Medical sciences > Psychology
Medical sciences > Psychology > Developmental psychology
ID Code:72355
Deposited On:25 May 2022 13:28
Last Modified:26 May 2022 07:23

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