Predictors of transitioning to adult mental health services and associated costs: a cross-country comparison

• Published in: BMJ mental health 2023-10, Vol.26 (1), p.e300814
• Main Authors: Appleton, Rebecca, Canaway, Alastair, Tuomainen, Helena, Dieleman, Gwen, Gerritsen, Suzanne, Overbeek, Mathilde, Maras, Athanasios, van Bodegom, Larissa, Franić, Tomislav, de Girolamo, Giovanni, Madan, Jason, McNicholas, Fiona, Purper-Ouakil, Diane, Schulze, Ulrike M E, Tremmery, Sabine, Singh, Swaran P
• Format: Article
• Language: English
• Subjects: Anxiety; Child & adolescent mental health; child & adolescent psychiatry; Child and Adolescent Mental Health; Cost control; Data collection; Emotional disorders; Health care expenditures; Health services; Life Sciences; Mental disorders; Mental health care; Mood disorders; Personality disorders; Suicides & suicide attempts; Teenagers; Variables
• ISSN: 2755-9734; 2755-9734
• DOI: 10.1136/bmjment-2023-300814

BackgroundYoung people are at risk of falling through the care gap after leaving child and adolescent mental health services (CAMHS) despite an ongoing need for mental health support. Currently, little is known about the predictors of transitioning to adult mental health services (AMHS), and associated healthcare and societal costs as young people cross the transition boundary.ObjectiveTo conduct a secondary data analysis exploring predictors of transitioning or falling through the gap and associated costs.MethodsData were used from a longitudinal study, which followed young people from seven European countries for 2 years after reaching their CAMHS boundary. Predictors of transitioning (including sociodemographic and clinical variables) and longitudinal resource use were compared for 488 young people who transitioned to AMHS versus those who fell through the gap.FindingsYoung people were more likely to transition to AMHS if they were severely ill. Those from Italy, the Netherlands and the UK were more likely to fall through the gap than transition to AMHS. Healthcare costs fell for all young people over the study, with a sharper decrease for those who fell through the gap.ConclusionsTotal healthcare costs fell for all participants, indicating that the intensity of mental health support reduces for all young people as they cross the CAMHS boundary, regardless of clinical need.Clinical implicationsIt is important that alternative forms of mental health support are available for young people who do not meet the AMHS care threshold but still have mental health needs after leaving CAMHS.