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Applied Theatre in Adolescent Mental Health Transition Care

the transition from child and adolescent Mental Health Services (caMHS) to adult Mental Health Services (aMHS) has been recognised as a key concern within healthcare, described as a ‘cliff edge’ by the House of commons Health committee, and ‘poorly planned, poorly executed and poorly experienced’ by the National Institute for Health research.1,2 this short article identifies one way of working in this area, together with plans to conduct research evaluating the initiative. caMHS and aMHS are very different services, with distinct histories, philosophies and approaches; adult psychiatry evolved out of the asylum, whereas child psychiatry emerged later and concerned itself more with developmental issues, education and family relationships. For a young person negotiating this interface (usually on turning 18, although sometimes younger, as services across the country do operate differently), it therefore does not simply involve adjusting to a new physical environment and new professionals, but also adapting to a service that considers them as autonomous adults, rather than as part of the family unit. as well as the level and style of intervention, differences in eligibility thresholds for referral also means that the remit for aMHS is narrower and they may get no input from services at all. When discussing (or referring to) transition, it is useful to distinguish this from transfer, where the latter is simply the termination of input from child services and the commencement of input from adult services. transition should be a therapeutic experience and involve preparation: ‘a period of handover or joint care, transition planning meetings (involving the young person and carer, and key caMHS and aMHS professionals) and transfer of case notes or information summaries’.3 Young people experiencing this quality of transition is, sadly, rare, and thus – while also recognising the need for systemic change, locally and nationally – support for young people negotiating the challenges of moving between services needs to be developed.