What is transition?

Transition is the term we use to describe moving on from child and adolescent mental health services (CAMHS) to another service which is better set up to help you.

This factsheet outlines what should happen when you are getting ready to move on.

 

Reasons for transition

You may be moving on from CAMHS because you are approaching your 18th birthday, or you may be moving on for different reasons such as having reached your treatment goals or moving house.

During your time with CAMHS, as you have been working towards your goals, you should have helped develop your ‘My Passport’ document, which will hopefully have helped you to understand what help you need now and in the future. 

 

Why do I need a transition?

Turning 18 is a milestone for many young people, with lots of potential changes such as going to University, getting a job or leaving home, you may even be progressing in a relationship, and as such your mental health and wellbeing needs can change.

If you still need specialist mental health services’ help after you turn 18 years old to reach your goals, then you will move on to adult services. However, if you reach your goals before you turn 18 years old and no longer need specialist mental health services’ help, you will be discharged back to your GP.

During transition we help you to plan and prepare for the changes ahead, whether this is being discharged back to your GP or moving to adult services.

 

When does transition happen?

Most CAMHS teams work with young people up until they are 18 years old.  Occasionally, if you are nearing the end of a therapy which is going really well and you don’t want to start again with a new worker, you can stay in CAMHS for a short while after your 18th birthday. 

Your CAMHS worker should start talking with you about moving on from CAMHS several months before it needs to happen.  Most of the time this happens from when you are 17½ years old; but if you have lots to arrange or lots of people working with you, it may be that this happens earlier, sometimes as early as 16½ years old.

 

What is a transition meeting?

To help think about what help or support you will need after you move on from CAMHS, you will be invited to a meeting to talk about it.  This will probably be called your transition meeting or Care Programme Approach (CPA) handover meeting (CPA is explained later on).

The meeting should include:

  • thinking about your goals
  • an assessment of your needs – mental health but also physical health, education/employment, social/family needs
  • a review of your previous and current care plans
  • thinking about future treatment, including talking therapies and medication
  • thinking about any further appointments – how often, when, where
  • a discussion about what happens if you do not attend your appointments

 

Who is involved in the transition meeting?

You and your parent/carer should be invited to the meeting, along with your CAMHS worker(s) and your new adult mental health worker.  If other people work closely with you, for example college staff, social worker, youth support worker, they can be at the meeting too. Your GP will be told about the meeting.

 

How do I remember what we agreed?

Anything that you, your parent/carer and mental health workers agreed with you should be written down, this is called a transition plan or a care plan, and it should be included in your ‘My Passport’ document.

It should include information about:

  • the name of your new worker
  • the date you will leave CAMHS
  • if any work will be done by both your CAMHS worker and your new adult worker together
  • who else knows about the agreement, for example your GP, social worker or college tutor
  • what other support might be available to you if you are not going to be moving on to adult mental health services.

 

Your ‘My Passport’ document will also have a section called THRIVE; this is a way of describing how much support you need with your mental health. Your CAMHS worker will explain this to you in more detail and you should discuss together which THRIVE category you are under at the time of planning your transition.

 

Will I have to tell my new team my story again?

Hopefully not, that is why it should all be written down in your transition plan and in your ‘My Passport’ document.

 

Will it be different in my new team compared to CAMHS?

Yes, adult services work differently to CAMHS and it is important that you know this so you don’t get any surprises.  For example, adult services will not include your parent/carer unless you ask them to, so the responsibility for opening letters with appointment dates in and going to appointments will be yours.

Adult services are also in different teams, such as the affective team (who help people with emotional/mood disorders, anxiety, ADHD etc), the psychosis team (who help people who hear voices, have psychosis, have schizophrenia and have other stressful experiences), and there are other specialist teams and inpatient units too.

 

Who works in adult services?

Adult mental health services are made up of different workers, just like your CAMHS team.  There are psychiatrists, psychologists, nurses, social workers, support workers, occupational therapists and physical health workers.

 

Where will I be seen?

You will have appointments either in a clinic or at your home, depending on what you have agreed with your new worker.

 

Can my parents/carers be involved?

Your parents/carers should be involved in planning your transition but after you have left CAMHS, they will be involved only if you want them to be. However, it may be that your parents/carers need ongoing support too; if they do, we can arrange for them to have a ‘carers’ assessment’.

 

Who do I call if I’m struggling?

Up until your 18th birthday, you can contact your CAMHS team and you should have the telephone number for your CAMHS worker. If there is one near where you live, you can also contact your local CAMHS crisis team. Your CAMHS worker will have talked with you about who to call if you’re struggling or in crisis.

After your 18th birthday, you will need to call your new adult worker and you should have that telephone number in your transition plan or in your ‘My Passport’ document.  There are also adult crisis teams if you are struggling in the evening, at night or at the weekend.

You can also call the GP or accident and emergency if you need medical help and they can contact mental health services for you.

You should have a list of telephone numbers for when you feel in crisis or if you need extra help.

 

Complicated needs / Care Programme Approach (CPA)

Sometimes there are lots of people involved in working to support you.  You might have heard people talk about CPA (Care Programme Approach), which is a way of making sure that the right care and treatment is provided to people with complex needs or who need a lot of support. 

CPA might be used with young people who:

  • have been in adolescent inpatient services
  • in community CAMHS who have severe mental illness
  • are in the looked after system (for example in foster care)
  • are subject to a Child Protection plan
  • are young carers
  • are involved with youth offending services
  • are not in education, employment or training
  • are homeless or using illegal drugs. 

CPA is also used in adult mental health services.

 

Confidentiality

You have the same rights to confidentiality whether you are under 18 or over 18.  We will protect your confidentiality and not talk to others about you, unless we are concerned that there is a real risk of harm to you, or to other people, or if we think a serious crime may be committed.

 

What if I’m not happy with the plan or the plan isn’t happening?

If you are not happy with the agreed transition plan or have any questions about it, you should tell your CAMHS worker.

It might be easier if you write down what you are not happy about or ask someone else to help explain it to your CAMHS worker. You can also ask for an advocate, who is someone that will work with you and is independent of CAMHS.

If you’re still not happy with your transition plan, you can contact our patient advice and liaison service (PALS), details of which can be found further in this document.

 

Other sources of help / websites

v1-www.tewv.clients.wtg.co.uk

Childline 0800 1111 or www.childline.org.uk

Samaritans 08457 90 90 90 (24 hours a day telephone service)

www.youngminds.org.uk

NHS choices at www.nhs.uk

www.minded/org.uk

 

Leaflet reference: L970
Version: V1
Date last updated: 17 / February / 2017
Archive date: 17 / November / 2019

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