2023-09-28 14:46:10 +00:00
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abstract: 'BackgroundPoor transitions to adult care from child and adolescent
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mental health services may increase the risk of disengagement and
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long-term negative outcomes. However, studies of transitions in mental
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health care are commonly difficult to administer and little is known
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about the determinants of successful transition. The persistence of
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health inequalities related to access, care, and outcome is now well
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accepted including the inverse care law which suggests that those most
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in need of services may be the least likely to obtain them. We sought to
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examine the pathways and determinants of transition, including the role
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of social class.MethodA retrospective systematic examination of
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electronic records and case notes of young people eligible to transition
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to adult care over a 4-year period across five Health and Social Care
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NHS Trusts in Northern Ireland.ResultsWe identified 373 service users
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eligible for transition. While a high proportion of eligible patients
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made the transition to adult services, very few received an optimal
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transition process and many dropped out of services or subsequently
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disengaged. Clinical factors, rather than social class, appear to be
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more influential in the transition pathway. However, those not in
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employment, education or training (NEET) were more likely (OR 3.04: 95\%
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CI 1.34, 6.91) to have been referred to Adult Mental Health Services
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(AMHS), as were those with a risk assessment or diagnosis (OR 4.89:
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2.45, 9.80 and OR 3.36: 1.78, 6.34), respectively.ConclusionsDespite the
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importance of a smoother transition to adult services, surprisingly, few
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patients experience this. There is a need for stronger standardised
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policies and guidelines to ensure optimal transitional care to AMHS. The
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barriers between different arms of psychiatry appear to persist. Joint
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working and shared arrangements between child and adolescent and adult
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mental health services should be fostered.'
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affiliation: 'Leavey, G (Corresponding Author), Ulster Univ, Bamford Ctr Mental Hlth
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\& Wellbeing, Cromore Rd, Coleraine, Londonderry, North Ireland.
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Leavey, Gerard; McGrellis, Sheena; Forbes, Trisha; Rosato, Michael; Bunting, Brendan;
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Divin, Natalie; Hughes, Lynette, Ulster Univ, Bamford Ctr Mental Hlth \& Wellbeing,
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Cromore Rd, Coleraine, Londonderry, North Ireland.
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Thampi, Annette, Belfast Hlth \& Social Care Trust, Belfast, Antrim, North Ireland.
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Davidson, Gavin, Queens Univ Belfast, Belfast, Antrim, North Ireland.
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Toal, Alicia, Voices Young People Care, Belfast, Antrim, North Ireland.
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Paul, Moli; Singh, Swaran P., Univ Warwick, Coventry, W Midlands, England.'
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author: Leavey, Gerard and McGrellis, Sheena and Forbes, Trisha and Thampi, Annette
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and Davidson, Gavin and Rosato, Michael and Bunting, Brendan and Divin, Natalie
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and Hughes, Lynette and Toal, Alicia and Paul, Moli and Singh, Swaran P.
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author-email: g.leavey@ulster.ac.uk
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author_list:
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- family: Leavey
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given: Gerard
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- family: McGrellis
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given: Sheena
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- family: Forbes
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given: Trisha
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- family: Thampi
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given: Annette
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- family: Davidson
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given: Gavin
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- family: Rosato
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given: Michael
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- family: Bunting
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given: Brendan
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- family: Divin
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given: Natalie
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- family: Hughes
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given: Lynette
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- family: Toal
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given: Alicia
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- family: Paul
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given: Moli
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- family: Singh
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given: Swaran P.
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da: '2023-09-28'
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doi: 10.1007/s00127-019-01684-z
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eissn: 1433-9285
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files: []
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issn: 0933-7954
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journal: SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY
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keywords: 'Child and adolescent; Mental health; Inequalities; Service provision;
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Transition'
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keywords-plus: CHILD; INEQUALITIES; GAP
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language: English
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month: AUG
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number: '8'
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number-of-cited-references: '25'
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orcid-numbers: 'Leavey, Gerard/0000-0001-8411-8919
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Davidson, Gavin/0000-0001-6003-0170
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Forbes, Trisha/0000-0003-2047-2956'
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pages: 955-963
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papis_id: 061540f432e1f4aa9eccacecdce455d3
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ref: Leavey2019improvingmental
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researcherid-numbers: 'Leavey, Gerard/AAU-2912-2020
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Forbes, Trisha/ISB-5690-2023
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'
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tags:
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- review
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times-cited: '14'
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title: 'Improving mental health pathways and care for adolescents in transition to
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adult services (IMPACT): a retrospective case note review of social and clinical
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determinants of transition'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000478101400008
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usage-count-last-180-days: '3'
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usage-count-since-2013: '12'
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volume: '54'
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web-of-science-categories: Psychiatry
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year: '2019'
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