1
|
Gerritsen SE, van Bodegom LS, Overbeek MM, van Staa A, Maras A, van Amelsvoort TA, Wolke D, de Girolamo G, Franić T, McNicholas F, Paul M, Purper-Ouakil D, Santosh P, Schulze UM, Singh SP, Street C, Tremmery S, Tuomainen H, Dieleman GC. Adaptation and validation of the On Your Own Feet - Transition Experiences Scale evaluating transitions to adult services among adolescent mental health service users in Europe. Psychiatry Res 2024; 339:116071. [PMID: 39083959 DOI: 10.1016/j.psychres.2024.116071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 06/27/2024] [Accepted: 06/29/2024] [Indexed: 08/02/2024]
Abstract
PURPOSE Experiences of young people transitioning from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) have mostly been investigated qualitatively. This study adapts and validates the On Your Own Feet - Transition Experiences Scale (OYOF-TES) in a sample of CAMHS users in Europe and describes young people's and parents' experiences with transition and end of care at CAMHS. METHODS The OYOF-TES was adapted to a mental health setting and translated. An End Of Care (OYOF-EOC) version (self- and parent-report) was developed. A total of 457 young people and 383 parents completed an OYOF-TES or OYOF-EOC. Psychometric properties and descriptives are presented. RESULTS The Cronbach's alphas of the OYOF-TES and OYOF-EOC parent/self-report ranged from 0.92 to 0.94. The two-factor structure was confirmed. The mean overall satisfaction reported by young people was 6.15 (0-10; SD=2.92) for transition and 7.14 (0-10; SD=2.37) for care ending. However, 26.7%-36.4% of young people were unsatisfied. DISCUSSION The OYOF-TES and OYOF-EOC can be used reliably in mental healthcare settings to capture young people's and parents' transition experiences. The majority of young people and parents was satisfied with the process of transition and care ending, yet a third of young people had negative experiences.
Collapse
Affiliation(s)
- Suzanne E Gerritsen
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Larissa S van Bodegom
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, the Netherlands; Yulius Mental Health Organization, Dordrecht, the Netherlands
| | - Mathilde M Overbeek
- Yulius Mental Health Organization, Dordrecht, the Netherlands; Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; ARQ National Psychotrauma Centre, Diemen, the Netherlands
| | - AnneLoes van Staa
- Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Athanasios Maras
- Yulius Mental Health Organization, Dordrecht, the Netherlands; ARQ National Psychotrauma Centre, Diemen, the Netherlands
| | - Therese Amj van Amelsvoort
- University of Maastricht, Maastricht, the Netherlands; Mondriaan Mental Health Care, Heerlen, the Netherlands
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | | | - Tomislav Franić
- IRCCS Instituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; School of Medicine, University of Split, Split, Croatia
| | - Fiona McNicholas
- School of Medicine & Medical Science, University College Dublin, Dublin, Republic of Ireland; Lucena CAMHS, SJOG, Dublin, Republic of Ireland
| | - Moli Paul
- Warwick Medical School, University of Warwick, Coventry, United Kingdom; Coventry and Warwickshire Partnership NHS Trust, Coventry, United Kingdom
| | - Diane Purper-Ouakil
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France; INSERM, CESP U1018, PsyDev, University Paris Saclay, UVSQ, Versailles, France
| | - Paramala Santosh
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom; Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, United Kingdom; HealthTracker Ltd, Kent, United Kingdom
| | - Ulrike Me Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Swaran P Singh
- Warwick Medical School, University of Warwick, Coventry, United Kingdom; Coventry and Warwickshire Partnership NHS Trust, Coventry, United Kingdom
| | - Cathy Street
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | | | - Helena Tuomainen
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Gwendolyn C Dieleman
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, the Netherlands.
| |
Collapse
|
2
|
Heera S, Beattie K, Punthakee Z, DiRezze B, Herrington J, Cellucci T, Heale L, Matsos M, Gorter JW, Batthish M. The TRUST Study-TRansition US Together: Evaluating the Impact of a Parent- and Adolescent-Centered Transition Toolkit on Transition Readiness in Patients with Juvenile Idiopathic Arthritis and Childhood-Onset Systemic Lupus Erythematosus. CHILDREN (BASEL, SWITZERLAND) 2024; 11:881. [PMID: 39062330 PMCID: PMC11276097 DOI: 10.3390/children11070881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/08/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVE Adolescents with chronic rheumatic disease must increasingly take on more responsibility for disease management from parents as they transition from pediatric to adult care. Yet, there are limited resources to inform and support parents about transition. Here, we evaluate the impact of a Transition Toolkit, geared towards parents and adolescents, on transition readiness, and explore the potential impact of parent-adolescent communication. METHODS A prospective cohort study of youths aged 14-18 years old and their parents was performed. Participant demographics, disease characteristics, transition readiness scores (Transition-Q, max 100), and parent-adolescent communication scores (PACS, max 100) were collected at enrollment (when the Transition Toolkit was shared with adolescents and their parents. Generalized estimating equation (GEE) analyses determined the influence of the Toolkit on transition readiness and explored the role of parent-adolescent communication quality. Subgroup analyses were conducted by sex. RESULTS A total of 21 patients were included; 19 completed one post-intervention Transition-Q and 16 completed two. Transition-Q scores increased over time and the rate of increase doubled after the Toolkit was shared (β = 7.8, p < 0.05, and β = 15.5, p < 0.05, respectively). CONCLUSION Transition readiness improved at each follow-up, the greatest increase was seen after the Toolkit was shared. Parent-adolescent communication quality did not appear to impact changes in transition readiness.
Collapse
Affiliation(s)
- Simran Heera
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 1C7, Canada; (S.H.); (B.D.); (J.H.)
| | - Karen Beattie
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4L8, Canada; (K.B.); (T.C.); (L.H.); (J.W.G.)
| | - Zubin Punthakee
- Department of Medicine, McMaster University, Hamilton, ON L8N 3Z5, Canada (M.M.)
| | - Briano DiRezze
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 1C7, Canada; (S.H.); (B.D.); (J.H.)
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada
| | - Julie Herrington
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 1C7, Canada; (S.H.); (B.D.); (J.H.)
| | - Tania Cellucci
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4L8, Canada; (K.B.); (T.C.); (L.H.); (J.W.G.)
| | - Liane Heale
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4L8, Canada; (K.B.); (T.C.); (L.H.); (J.W.G.)
| | - Mark Matsos
- Department of Medicine, McMaster University, Hamilton, ON L8N 3Z5, Canada (M.M.)
| | - Jan Willem Gorter
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4L8, Canada; (K.B.); (T.C.); (L.H.); (J.W.G.)
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada
| | - Michelle Batthish
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4L8, Canada; (K.B.); (T.C.); (L.H.); (J.W.G.)
| |
Collapse
|
3
|
Boonstra A, Leijdesdorff S, Street C, Holme I, van Bodegom L, Franić T, Appleton R, Tah P, Tuomainen H, Tomljenovic H, McNicholas F, van Amelsvoort T. Turning 18 in mental health services: a multicountry qualitative study of service user experiences and views. Ir J Psychol Med 2024:1-9. [PMID: 38562092 DOI: 10.1017/ipm.2024.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
BACKGROUND Worldwide, the division between Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) has frequently resulted in fragmented care with an unprepared, non-gradual transition. To improve continuity of care and other service transition experiences, service user input is essential. However, such previous qualitative studies are from a decade ago or focused on one mental disorder or country. The aim of the present study was to learn from service users' transition experiences and suggested improvements. METHODS Semi-structured interviews were held with young people aged 18-24 and/or parents/caregivers in the United Kingdom, Ireland, the Netherlands and Croatia. Inclusion was based on the experience of specialist mental health care before and after turning 18. Thematic analysis of transcribed and translated interview transcripts was performed using ATLAS.ti 9. RESULTS Main themes of service user experiences included abrupt changes in responsibilities, various barriers and a lack of preparation, communication and ongoing care. Young people expressed a great need for continuity of care. Their suggestions to improve transitional care included early and adequate preparation, joint working, improved communication from and between services, overlapping services, staying at CAMHS for longer and designated youth mental health teams. CONCLUSIONS Young people who experienced care before and after turning 18 suggested either altering the age limits of services or ensuring early preparation and communication regarding the transition and finding AHMS. This communication should include general changes when turning 18. Further considerations include increasing collaboration and overlap between CAMHS and AMHS.
Collapse
Affiliation(s)
- Anouk Boonstra
- School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Sophie Leijdesdorff
- School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Cathy Street
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Ingrid Holme
- School of Political Science and Sociology, University of Galway, Galway, Ireland
| | - Larissa van Bodegom
- Yulius Mental Health Organization, Yulius Academy, Dordrecht, The Netherlands
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Tomislav Franić
- Department of Psychiatry, Clinical Hospital Center Split, Split, Croatia
| | - Rebecca Appleton
- Division of Psychiatry, NIHR Mental Health Policy Research Unit, University College London, London, UK
| | - Priya Tah
- Department of Education, University of Oxford, Oxford, UK
| | | | - Helena Tomljenovic
- Department of Psychiatry, Clinical Hospital Center Split, Split, Croatia
| | - Fiona McNicholas
- Department of Child & Adolescent Psychiatry, University College Dublin, Dublin, Ireland
| | - Thérèse van Amelsvoort
- School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
4
|
Livanou M, Bull M, Manitsa I, Hunt J, Lane R, Heneghan A. Co-producing a complex psychosocial intervention during COVID-19 with young people transitioning from adolescent secure hospitals to adult services in England: Moving Forward intervention (MFi). Child Adolesc Ment Health 2024; 29:43-55. [PMID: 37455024 DOI: 10.1111/camh.12667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/09/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Young people moving from adolescent secure hospitals to adult care present with multiple and complex needs which often remain unmet during transition periods. This paper delineates the process of developing and co-producing the moving forward intervention (MFi), which aims to address the psychosocial needs of transitioning youth who have limited access to well-researched and tailored service provisions. METHOD An extensive search of the relevant literature was conducted to generate themes and guide the co-production phase. Fourteen Advisory Group Meetings were held virtually during COVID-19 to design the MFi module content with 17 keyworkers, 2 parents and 13 young people aged 17-18 years across six adolescent secure hospitals in England. Thematic analysis was used to reflect on the field notes discussed in the Advisory Groups. RESULTS Co-produced themes from the literature and the Advisory Groups informed the development of the proposed intervention. Three overarching themes pertinent to expectations in adult services, improving communication gaps between services and facilitating the letting go period emerged from the co-production phase. It was suggested the MFi is co-delivered by a peer with lived experience to build trust and create hopefulness among young people. The importance of promoting graded transitions through standardised procedures was highlighted. CONCLUSIONS The current findings promote evidence-based initiatives and build robust practice frameworks that inform treatment and policy guidelines. The young people, parents and keyworkers found the MFi supportive and valued the co-production experience. As such, co-production has been a vital tool in promoting patient engagement and empowerment, and reducing service inequalities, especially in adolescent secure hospitals.
Collapse
Affiliation(s)
- Maria Livanou
- Department of Psychology, School of Mental Health & Psychological Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Kingston University Department of Psychology, School of Law, Social and Behavioural Sciences, Kingston University London, Kingston Upon Thames, UK
| | - Marcus Bull
- Kingston University Department of Psychology, School of Law, Social and Behavioural Sciences, Kingston University London, Kingston Upon Thames, UK
| | - Ifigeneia Manitsa
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Jodie Hunt
- Kingston University Department of Psychology, School of Law, Social and Behavioural Sciences, Kingston University London, Kingston Upon Thames, UK
| | - Rebecca Lane
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
- Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Anya Heneghan
- Department of Psychology, School of Mental Health & Psychological Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| |
Collapse
|
5
|
Janssens A, Blake S, Eke H, Price A, Ford T. Parenting roles for young people with attention-deficit/hyperactivity disorder transitioning to adult services. Dev Med Child Neurol 2023; 65:136-144. [PMID: 35723621 PMCID: PMC10083944 DOI: 10.1111/dmcn.15320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 11/27/2022]
Abstract
AIM To inform transitions from child to adult health services, we explored the work and roles parents take in the care of young people with attention-deficit/hyperactivity disorder (ADHD) aged 14 to 25 years old. METHOD Using framework thematic analysis, we analysed data collected from 28 semi-structured interviews with parents of young people with ADHD to generate a typology and triangulated it against findings from 64 interviews with young people with ADHD. The interviews were carried out as part of a three-strand, interactive mixed-method study. RESULTS An entourage typology of three parent roles was identified. Parents moved between 'manager' and 'roadie' roles as their child gradually matured. A 'superfan' role was identified which supported young people's positive self-image but may impede withdrawal from the 'manager' role. Continued parental involvement into adulthood reflected a need to maintain the balance of resources required to maintain quality of life for the whole family. INTERPRETATION This is the first study to explore parental roles in the health care of young people with ADHD. Parents will vary in their capacity to fulfil the identified roles and step back their care as their children reach adulthood. The findings can inform intervention development to support families and transition between services. WHAT THIS PAPER ADDS Parents move from a 'manager' to 'roadie' role as young people mature. A 'superfan' role supports positive self-image and directed health care work. Continued involvement reflects parental responsibility to juggle wider family needs and resources. Parents differ in capacity to fulfil and move between these roles.
Collapse
Affiliation(s)
- Astrid Janssens
- User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense C, Denmark.,Center for Forskning Sammen med Patienter og Pårørende, Odense University Hospital, Denmark.,University of Exeter Medical School, Exeter
| | - Sharon Blake
- University of Exeter Medical School, Exeter.,Law School, University of Exeter, Exeter
| | - Helen Eke
- University of Exeter Medical School, Exeter
| | - Anna Price
- University of Exeter Medical School, Exeter
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| |
Collapse
|
6
|
Lång U, Ramsay H, Yates K, Veijola J, Gyllenberg D, Clarke MC, Leacy FP, Gissler M, Kelleher I. Potential for prediction of psychosis and bipolar disorder in Child and Adolescent Mental Health Services: a longitudinal register study of all people born in Finland in 1987. World Psychiatry 2022; 21:436-443. [PMID: 36073707 PMCID: PMC9453911 DOI: 10.1002/wps.21009] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Current strategies to predict psychosis identify only a small proportion of individuals at risk. Additional strategies are needed to increase capacity for pre-diction and prevention of serious mental illness, ideally during childhood and adolescence. One possible approach would be to investigate systems in which psychosis risk factors are concentrated during childhood. One notable such system is represented by Child and Adolescent Mental Health Services (CAMHS). Although psychotic disorders are uncommon in CAMHS, many risk factors for psychosis are highly prevalent in young people who enter this system. We hypothesized, therefore, that youth attending CAMHS would be a high-risk group for psychosis if followed into adulthood and, furthermore, that CAMHS systems would capture a substantial proportion of future psychosis cases. We constructed a total population cohort study of all Finns born in 1987 (N=55,875), linking together extensive register data on health care contacts from birth through age 28 years. We identified all individuals diagnosed with a psychotic or bipolar disorder by age 28 (N=1,785). The risk of psychosis/bipolar disorder by age 28 years was 1.8% for individuals who had not attended CAMHS during childhood or adolescence, whereas it was 12.8% for those with a history of any outpatient CAMHS contact (odds ratio, OR=7.9, 95% CI: 7.2-8.7). Furthermore, the risk of psychosis/bipolar disorder by age 28 years was 2.3% for individuals without a history of inpatient CAMHS admission, whereas it was 24.0% for those with a history of inpatient CAMHS admission (OR=13.3, 95% CI: 11.9-14.9), and 36.5% for those with a history of inpatient CAMHS admission in adolescence (age 13-17 years) (OR=24.2, 95% CI: 21.2-27.6). Individuals who attended CAMHS but received no mental disorder diagnosis had an equally high risk of subsequently developing a psychosis/bipolar disorder as individuals who did receive a diagnosis (OR=0.9, 99.5% CI: 0.7-1.1). Compared to other CAMHS attendees, individuals who developed psychosis or bipolar disorder were more likely to have had an initial CAMHS diagnosis of depressive or other mood disorder (OR=2.3, 99.5% CI: 1.6-3.0) and disruptive behaviour disorder (OR=1.7, 99.5% CI: 1.2-2.5). Of all psychosis/bipolar diagnoses by age 28 years, 50.2% occurred in individuals who had, at some point in childhood or adolescence, attended CAMHS, indicating that CAMHS represent not only a high-risk but also a high-capacity system for prediction of psychosis/bipolar disorder. These findings suggest an enormous, untapped potential for large-scale psychosis/bipolar disorder prediction and prevention research within existing specialist CAMHS.
Collapse
Affiliation(s)
- Ulla Lång
- School of Medicine, University College Dublin, Health Science CentreDublinIreland,Department of PsychiatryRCSI University of Medicine and Health SciencesDublinIreland
| | - Hugh Ramsay
- School of Medicine, University College Dublin, Health Science CentreDublinIreland,St. Michael's HouseDublinIreland
| | - Kathryn Yates
- Department of PsychiatryRCSI University of Medicine and Health SciencesDublinIreland
| | - Juha Veijola
- Research Unit of Clinical Neuroscience, Department of PsychiatryUniversity of OuluOuluFinland,Department of PsychiatryUniversity Hospital of OuluOuluFinland
| | - David Gyllenberg
- Department of Child Psychiatry and INVEST Research Flagship CenterUniversity of TurkuTurkuFinland,Turku University HospitalTurkuFinland,Department of Adolescent PsychiatryUniversity of HelsinkiHelsinkiFinland,Helsinki University Central HospitalHelsinkiFinland,Welfare DepartmentNational Institute for Health and WelfareHelsinkiFinland
| | - Mary C. Clarke
- Department of PsychiatryRCSI University of Medicine and Health SciencesDublinIreland,Department of PsychologyRCSI University of Medicine and Health SciencesDublinIreland
| | - Finbarr P. Leacy
- Health Products Regulatory AuthorityEarlsfort CentreDublinIreland
| | - Mika Gissler
- Information Services DepartmentNational Institute of Health and WelfareHelsinkiFinland,Research Centre for Child PsychiatryUniversity of TurkuTurkuFinland,Department of Molecular Medicine and SurgeryKarolinska InstituteStockholmSweden,Academic Primary Health Care CentreRegion StockholmStockholmSweden
| | - Ian Kelleher
- School of Medicine, University College Dublin, Health Science CentreDublinIreland,Department of PsychiatryRCSI University of Medicine and Health SciencesDublinIreland,Lucena Clinic Child and Adolescent Mental Health ServiceSt. John of God Hospitaller ServicesDublinIreland,Division of Psychiatry, Centre for Clinical Brain Sciences, Royal Edinburgh HospitalUniversity of EdinburghEdinburghUK
| |
Collapse
|
7
|
Bory C, Schmutte T, Davidson L, Plant R. Predictive modeling of service discontinuation in transitional age youth with recent behavioral health service use. Health Serv Res 2022; 57:152-158. [PMID: 34396526 PMCID: PMC8763280 DOI: 10.1111/1475-6773.13871] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/12/2021] [Accepted: 08/02/2021] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE To develop and test predictive models of discontinuation of behavioral health service use within 12 months in transitional age youth with recent behavioral health service use. DATA SOURCES Administrative claims for Medicaid beneficiaries aged 15-26 years in Connecticut. STUDY DESIGN We compared the performance of a decision tree, random forest, and gradient boosting machine learning algorithms to logistic regression in predicting service discontinuation within 12 months among beneficiaries using behavioral health services. DATA EXTRACTION We identified 33,532 transitional age youth with ≥1 claim for a primary behavioral health diagnosis in 2016 and Medicaid enrollment of ≥11 months in 2016 and ≥11 months in 2017. PRINCIPAL FINDINGS Classification accuracy for identifying youth who discontinued behavioral health service use was highest for gradient boosting (80%, AUC = 0.86), decision tree (79%, AUC = 0.84), and random forest (79%, AUC = 0.86), as compared with logistic regression (71%, AUC = 0.71). CONCLUSIONS Predictive models based on Medicaid claims can assist in identifying transitional age youth who are at risk of discontinuing from behavioral health care within 12 months, thus allowing for proactive assessment and outreach to promote continuity of care for younger persons who have behavioral health needs.
Collapse
Affiliation(s)
| | - Timothy Schmutte
- Department of Psychiatry, School of MedicineYale UniversityNew HavenConnecticutUSA
| | - Larry Davidson
- Department of Psychiatry, School of MedicineYale UniversityNew HavenConnecticutUSA
| | | |
Collapse
|
8
|
Lockertsen V, Holm LAW, Nilsen L, Rø Ø, Burger LM, Røssberg JI. The transition process between child and adolescent mental services and adult mental health services for patients with anorexia nervosa: a qualitative study of the parents' experiences. J Eat Disord 2021; 9:45. [PMID: 33849646 PMCID: PMC8045171 DOI: 10.1186/s40337-021-00404-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/04/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Patients with Anorexia Nervosa (AN) often experience the transition between Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) as challenging. This period tends to have a negative influence on the continuity of care for the adolescents and represents a demanding and difficult period for the parents. To our knowledge, no previous study has explored the parents' experience with the transition from CAMHS to AMHS. Therefore, this qualitative study examines how parents experience the transition process from CAMHS to AMHS. METHODS In collaboration with a service user with carer experience, qualitative interviews were conducted with 10 parents who had experienced the transition from CAMHS to AMHS, some from outpatient care and others from both in- and outpatient mental care units in Norway. All had some experience with specialized eating disorder units. The interviews were analyzed with a Systematic Text Condensation (STC) approach. Service users' perspectives were involved in all steps of the research process. RESULTS Six categories represent the parents' experiences of the transition: (1) the discharge when the child turns 18 years old is sudden; (2) the lack of continuity is often followed by deterioration and relapses in the patient; (3) the lack of involvement and information causes distress; (4) knowledge - an important factor for developing a trusting relationship between parents` and clinicians`; (5) parents have overwhelming multifaceted responsibilities; and (6) parents need professional support. CONCLUSION Improving the transition by including parents and adolescents and preparing them for the transition period could ease parental caregiving distress and improve adolescents' compliance with treatment. Clinicians should increase their focus on the important role of parents in the transition process. The system should implement routines and guidelines to offer caregivers support and guidance during the transition process.
Collapse
Affiliation(s)
- Veronica Lockertsen
- Division of Mental Health and Addiction, Oslo University Hospital, P.O. Box 4959, Nydalen, Oslo, Norway.
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0318, Oslo, Norway.
| | | | - Liv Nilsen
- Division of Mental Health and Addiction, Oslo University Hospital, P.O. Box 4959, Nydalen, Oslo, Norway
| | - Øyvind Rø
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0318, Oslo, Norway
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Ullevål HF, Postboks 4950 Nydalen, 0424, Oslo, Norway
| | | | - Jan Ivar Røssberg
- Division of Mental Health and Addiction, Oslo University Hospital, P.O. Box 4959, Nydalen, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0318, Oslo, Norway
| |
Collapse
|
9
|
Ougrin D. Editorial: The job of an editor-one year on. Child Adolesc Ment Health 2019; 24:293-294. [PMID: 32677349 DOI: 10.1111/camh.12354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Incredible as it still sounds to me, it has now been a year since I took over as the editor-in-chief of Child and Adolescent Mental Health. It is time to both look back and look forward. Over the past year, my approach remained unchanged: CAMH should grow to become a leading source of the most clinically relevant knowledge worldwide in our field. I would like you, our readers, to think of CAMH whenever you need clinical advice, a research update, or an innovative service development idea.
Collapse
Affiliation(s)
- Dennis Ougrin
- Department of Child and Adolescent Psychiatry, King's College London, London, UK
| |
Collapse
|