Effect of managed transition on mental health outcomes for young people at the child-adult mental health service boundary: a randomised clinical trial.

Adolescent Humans Adult Mental Health Services Mental Health Europe Psychotic Disorders Outcome Assessment, Health Care
HoNOSCA Transition adolescent cluster randomised controlled trial mental disorders mental health services structured assessment

Journal

Psychological medicine
ISSN: 1469-8978
Titre abrégé: Psychol Med
Pays: England
ID NLM: 1254142

Informations de publication

Date de publication:
04 2023
Historique:
medline: 15 6 2023
pubmed: 13 6 2023
entrez: 13 6 2023
Statut: ppublish

Résumé

Poor transition planning contributes to discontinuity of care at the child-adult mental health service boundary (SB), adversely affecting mental health outcomes in young people (YP). The aim of the study was to determine whether managed transition (MT) improves mental health outcomes of YP reaching the child/adolescent mental health service (CAMHS) boundary compared with usual care (UC). A two-arm cluster-randomised trial (ISRCTN83240263 and NCT03013595) with clusters allocated 1:2 between MT and UC. Recruitment took place in 40 CAMHS (eight European countries) between October 2015 and December 2016. Eligible participants were CAMHS service users who were receiving treatment or had a diagnosed mental disorder, had an IQ ⩾ 70 and were within 1 year of reaching the SB. MT was a multi-component intervention that included CAMHS training, systematic identification of YP approaching SB, a structured assessment (Transition Readiness and Appropriateness Measure) and sharing of information between CAMHS and adult mental health services. The primary outcome was HoNOSCA (Health of the Nation Outcome Scale for Children and Adolescents) score 15-months post-entry to the trial. The mean difference in HoNOSCA scores between the MT and UC arms at 15 months was -1.11 points (95% confidence interval -2.07 to -0.14, MT led to improved mental health of YP after the SB but the magnitude of the effect was small. The intervention can be implemented at low cost and form part of planned and purposeful transitional care.

Sections du résumé

BACKGROUND
Poor transition planning contributes to discontinuity of care at the child-adult mental health service boundary (SB), adversely affecting mental health outcomes in young people (YP). The aim of the study was to determine whether managed transition (MT) improves mental health outcomes of YP reaching the child/adolescent mental health service (CAMHS) boundary compared with usual care (UC).
METHODS
A two-arm cluster-randomised trial (ISRCTN83240263 and NCT03013595) with clusters allocated 1:2 between MT and UC. Recruitment took place in 40 CAMHS (eight European countries) between October 2015 and December 2016. Eligible participants were CAMHS service users who were receiving treatment or had a diagnosed mental disorder, had an IQ ⩾ 70 and were within 1 year of reaching the SB. MT was a multi-component intervention that included CAMHS training, systematic identification of YP approaching SB, a structured assessment (Transition Readiness and Appropriateness Measure) and sharing of information between CAMHS and adult mental health services. The primary outcome was HoNOSCA (Health of the Nation Outcome Scale for Children and Adolescents) score 15-months post-entry to the trial.
RESULTS
The mean difference in HoNOSCA scores between the MT and UC arms at 15 months was -1.11 points (95% confidence interval -2.07 to -0.14,
CONCLUSIONS
MT led to improved mental health of YP after the SB but the magnitude of the effect was small. The intervention can be implemented at low cost and form part of planned and purposeful transitional care.

Identifiants

DOI: 10.1017/S0033291721003901 PMID: 37310306 PMC: PMC10123823
pubmed: 37310306
doi: 10.1017/S0033291721003901
pii: S0033291721003901
pmc: PMC10123823
doi:

Types de publication

Randomized Controlled Trial Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2193-2204

Investigateurs

Swaran Singh (S)
Helena Tuomainen (H)
Jason Madan (J)
Moli Paul (M)
Cathy Street (C)
Dieter Wolke (D)
Jane Warwick (J)
Claire Daffern (C)
Paramala Santosh (P)
Federico Fiori (F)
Giovanni de Girolamo (G)
Diane Purper-Ouakil (D)
Athanasios Maras (A)
Frank Verhulst (F)
Gwen C Dieleman (GC)
Ulrike Schulze (U)
Andrea Wohner (A)
Sabine Tremmery (S)
Fiona McNicholas (F)
Tomislav Franić (T)
Maryann Davis (M)
Pat McGorry (P)
Adriana Mihai (A)
Norman Sartorius (N)
Priya Tah (P)
Alastair Canaway (A)
James Griffin (J)
Rebecca Appleton (R)
Philip Wells (P)
Natalie Heaney (N)
Kate Lievesley (K)
Mathilde Mastroianni (M)
Jatinder Singh (J)
Laura Adams (L)
Giulia Signorini (G)
Alessandro Ferrari (A)
Elisa Gheza (E)
Cecilia Ferrari (C)
Laura Rivolta (L)
Flavia Levi (F)
Maria Cataldo (M)
Lidia Manenti (L)
Giorgia Morini (G)
Adriana Pastore (A)
Pamela Stagni (P)
Cecilia Toselli (C)
Pamela Varvara (P)
Frédérick Russet (F)
Virginie Maurice (V)
Véronique Humbertclaude (V)
Larissa S van Bodegom (LS)
Mathilde M Overbeek (MM)
Suzanne E Gerritsen (SE)
Melanie Saam (M)
Ulrike Breuninger (U)
Gaëlle Hendrickx (G)
Veronique De Roeck (V)
Ingrid Holme (I)
Aleksandra Gronostaj (A)
Rachael McKenna (R)
Lesley O'Hara (L)
Nikolina Davidović (N)
Helena Tomljenovic (H)
Amanda Tuffrey (A)
Anna Wilson (A)
Charlotte Gatherer (C)
Leanne Walker (L)
Jo Berriman (J)
Vinuthna Pemmaraju (V)
Michael Slowik (M)
Ben Rogers (B)
Alan Farmer (A)
Paramala Santosh (P)
Giovanni Allibrio (G)
Marco Armandi (M)
Angelo Bertani (A)
Giuseppe Carrà (G)
Patrizia Conti (P)
Sabrina Ferrari (S)
Francesco Margari (F)
Ottaviano Martinelli (O)
Renata Nacinovich (R)
Paolo Scocco (P)
Paolo Stagi (P)
Fabio Vanni (F)
Stefano Vicari (S)
Mario Speranza (M)
Hélène Lida-Pulik (H)
Renaud Jardri (R)
Aesa Parenti (A)
David Da Fonseca (D)
Isabelle Charvin (I)
Frédérique Bonnet-Brilhault (F)
Chrystèle Bodier (C)
Catherine Prigent (C)
Aurélie Schandrin (A)
Therese van Amelsvoort (T)
Albert Boon (A)
Arno van Dam (A)
Jörg M Fegert (JM)
Renate Schepker (R)
Elena Tanase (E)
Beata Williams (B)
Michele Noterdaeme (M)
Anne Sartor (A)
Vehbi Sakar (V)
Caroline von Bentzel (C)
Emmanuel Nelis (E)
Dirk van West (D)
Catherine Klockaerts (C)
Ann Pepermans (A)
Marina Danckaerts (M)
Anne Roekens (A)
Hanne Van Gutschoven (H)
Christel Lippens (C)
Jean-Pierre Ermans (JP)
Helen Keeley (H)
Keith Holmes (K)
James McDonald (J)
Maria Migone (M)
Fionnuala Lynch (F)
Elaine Healy (E)
Peter Dineen (P)
Vlatka Kovač (V)
Katarina Dodig-Ćurković (K)

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Auteurs

S P Singh (SP)

Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.
Coventry and Warwickshire Partnership NHS Trust, Coventry, UK.

H Tuomainen (H)

Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.

G Bouliotis (G)

Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.

A Canaway (A)

Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.

G De Girolamo (G)

IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.

G C Dieleman (GC)

Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, the Netherlands.

T Franić (T)

Department of Psychiatry, Clinical Hospital Center Split, Split, Croatia.

J Madan (J)

Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.

A Maras (A)

Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, the Netherlands.
Yulius Academy, Rotterdam, the Netherlands.

F McNicholas (F)

Department of Child and Adolescent Psychiatry, University College Dublin School of Medicine and Medical Science, Dublin, Republic of Ireland.
Geary Institute, University College Dublin, Dublin, Republic of Ireland.
Department of Child Psychiatry, Our Lady's Hospital for Sick Children, Dublin, Republic of Ireland.
Lucena Clinic SJOG, Dublin, Republic of Ireland.

M Paul (M)

Coventry and Warwickshire Partnership NHS Trust, Coventry, UK.

D Purper-Ouakil (D)

Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Unit of Child and Adolescent Psychiatry (MPEA1), Montpellier, France.

P Santosh (P)

Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), National and Specialist Child and Adolescent Mental Health Services, Maudsley Hospital, London, UK.
HealthTracker Ltd, Gillingham, UK.

U M E Schulze (UME)

Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.

C Street (C)

Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.

S Tremmery (S)

Department of Neurosciences, Child & Adolescent Psychiatry, University of Leuven, Leuven, Belgium.

F C Verhulst (FC)

Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, the Netherlands.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

P Wells (P)

Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.

D Wolke (D)

Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.
Department of Psychology, University of Warwick, Coventry, UK.

J Warwick (J)

Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adolescent › Effect of managed transition on mental health...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Effect of managed transition on mental health...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Effect of managed transition on mental health...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Services de santé mentale › Effect of managed transition on mental health...
questionsmedicales.fr › Caractéristiques de la population › Santé › Santé mentale › Effect of managed transition on mental health...
questionsmedicales.fr › Régions géographiques › Europe › Effect of managed transition on mental health...
questionsmedicales.fr › Troubles mentaux › Schizophrénie et troubles avec traits psychotiques › Troubles psychotiques › Effect of managed transition on mental health...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Effect of managed transition on mental health...