June 19, 2024

Vita Nectar

Health is the main investment in life

Transitioning From Child to Adult Mental Health Services for Eating Disorders

3 min read

Young people with eating disorders (EDs) face difficult transitions from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS), according to systematic review findings published in the Journal of Eating Disorders. The review also found that these transitions are challenging for providers and caregivers as well.

The age of onset for EDS is typically in adolescence and often persists into adulthood. Given the widespread complications associated with EDS, these disorders have the highest mortality rate of any psychiatric disease. Thus, the transition from CAMHS to AMHS is crucial for establishing ongoing care. Yet, it is common for young people to lose contact with mental health services for eating disorders after CAMHS discharge. Therefore, investigators conducted a systematic review to provide a comprehensive overview of care transitions for young people with eating disorders and to develop an evidence-informed transition framework.

The investigators searched publication databases from inception through November 2023 for peer-reviewed retrospective or prospective studies in English examining the transition from CAMHS to AMHS for young people with eating disorders. Studies that evaluated the transitions from CAMHS to AMHS for an ED among either young people (15 to 25 years of age) diagnosed with any ED (duration, severity, type) or caregivers and providers of this patient population were included.

The investigators included 14 studies in their review for a pooled sample size of 747 participants. Of the 14 studies, 10 were qualitative, 2 were cross-sectional, and 2 were longitudinal cohort studies. The included studies were conducted in England (36%), Canada (36%), Norway (21%) and France (7%). Overall, 5 studies recruited patients (n=559), 4 studies recruited providers (n=87), 1 study recruited caregivers (n=12), and 4 studies recruited a combination (n=89).

Based on the present review, transitions from CAMHS to AMHS for EDs are complex, multifaceted, and challenging for patients, caregivers, and providers alike.

Overall, the investigators found that patients, providers, and caregivers all experienced challenging transitions from CAMHS to AMHS. The issues in care continuity were multifaceted and complex due to the combination of patient ambivalence towards recovery, timing of ED onset and transition, and differences between child and adult services. For patients, transitions at 18 years of age coincided with major life events (eg, leaving home, vocational changes, biological changes) which further aggregate cognitive and behavioral symptoms.

On a systemic level, poor transitions are likely due to poor transfer alliance between services, lack of provider competency in transitioning ED patients, and administrative issues in medical record transfers. The investigators stated they were uncertain whether transitions remain problematic in the longer term.

The investigators noted most included studies were of moderate-to-high quality. The investigators used their findings to develop transition strategies to facilitate the transfer across CAMHS to AMHS programs. The transition strategies include timely discussions with patients when they are 14 to 18 years of age, an evaluation of patient readiness for transition, the inclusion of patients and caregivers in transition discussions, providing patients and caregivers with resources prior to AMHS, and greater communication and collaboration between services and providers.

“Based on the present review, transitions from CAMHS to AMHS for EDs are complex, multifaceted, and challenging for patients, caregivers, and providers alike,” the investigators concluded.

The primary limitation of the findings is the low sample size of studies evaluating transitions of care for EDs.


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