Transitions from child and adolescent mental health services to adult services

Healthwatch Wandsworth undertook a consultation to explore the experiences of young people, carers, professionals and other stakeholders regarding the transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). The work was prompted by evidence that many young people experience disruptions in care when they reach adulthood and move between services. The consultation aimed to identify gaps and improvements that could support a smoother transition process in Wandsworth. 

A total of 17 survey responses and two online poll responses were received. Participants included service users, carers, service providers, healthcare professionals, parents and other interested individuals. More than 60% of respondents had either experienced the transition process themselves or knew someone who had. 

Respondents generally praised the commitment and attitude of CAMHS staff. Positive feedback highlighted staff who were approachable, understanding and willing to work collaboratively with young people and families. Service providers also reported positive working relationships with CAMHS teams and appreciated their efforts to represent young people's needs. 

However, positive experiences were often tempered by concerns that services were difficult to access and did not always provide adequate support. Some service users reported receiving friendly but limited help, while others described waiting more than a year for assessment. 

The consultation revealed four consistent concerns across all respondent groups:

• Long waiting times: Many participants reported lengthy delays for assessments, appointments and treatment, sometimes leaving young people without support for extended periods. 
• High eligibility thresholds: Respondents repeatedly stated that CAMHS acceptance criteria were too restrictive, meaning that many young people struggled to access support until their mental health difficulties had become more severe. 
• Limited support availability: Participants felt that services were often under-resourced, with insufficient staffing and a limited number of therapeutic sessions available. 
• Lack of early intervention: Carers and professionals believed that earlier support could prevent mental health problems from worsening and reduce the need for more intensive services later. 

There was no clear consensus about the ideal age range for a transition service. However, many respondents felt support should begin before a young person reaches 18 and continue beyond that age if needed. Service providers commonly suggested transition support should start at 16 or 17 and continue until 25. Other respondents argued that support should be based on individual need rather than fixed age limits. 

The findings suggested that mental health transitions should be flexible, tailored and responsive to each young person's circumstances rather than driven solely by age-based service boundaries. 

Respondents emphasised that young people require support extending beyond clinical treatment alone. Many highlighted the need for help with housing, employment, education, finances and social inclusion alongside ongoing emotional and therapeutic support. 

There was strong support for consistent key workers, peer support, mentoring schemes and safe spaces where young people could build social connections and access activities. Many respondents believed that continuity of relationships and support was essential to prevent young people feeling abandoned when moving into adult services. 

Around 70% of respondents believed that transition arrangements should either continue beyond 18 or be adapted for young people with learning difficulties or disabilities. Others felt that support should be determined through individual assessment rather than through a specific age threshold. Respondents emphasised the importance of recognising additional needs and, where appropriate, involving families in planning and decision-making. 

Respondents made a number of recommendations for Wandsworth Council and the Clinical Commissioning Group. These included:

• Providing earlier intervention and support before problems reach crisis point. 
• Improving communication between CAMHS, adult services, families, schools and young people. 
• Making transition planning more personalised and involving young people directly in decisions about their future care. 
• Increasing staffing levels and therapeutic resources. 
• Ensuring continuity through key workers or transition coordinators. 
• Improving access to housing, employment, education and social support services.