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 services will 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 specialist 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 specialist CAMHS for a short while after your 18th birthday.
Your specialist CAMHS worker should start talking with you about moving on from specialist 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
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.
If I transfer to adult mental health services, what will it be like?
Adult mental health services work differently to CAMHS and it is important to understand how they work 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.
Can my parents/carers be involved in my transition?
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’.
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.
Who do I call if I am struggling?
If you are in specialist CAMHS services up until your 18th birthday, you can continue to contact your CAMHS team in the usual way. You can also contact your local CAMHS crisis team.
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.
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.