Young people’s mental health symptoms don’t worsen after leaving CAMHS

Most young people who stop using childhood and adolescent mental health services (CAMHS) after reaching the upper age limit do not see a decline in their symptoms, a new study has found.

The research, published in The Lancet Psychiatry, found that young people who left CAMHS and received no further care reported fewer problems with their mental health than those young people who transitioned to adult mental health services (AMHS).

The study, which involved universities across Europe, including the University of Warwick and Erasmus Medical Centre, Rotterdam, carried out repeated assessments on the mental health of 700 young people, with an average age of 17.5 years, over a two-year period. During this period the young people, who were based in eight European countries, either transitioned from CAMHS to AMHS, stayed in CAMHS, or left mental health care altogether.

Approximately half of young people who reach the upper age limit of their country’s CAMHS (typically between 16 and 19) stop using mental health services altogether. This is not associated with a deterioration in their mental health the study found.

The research also found that those with more severe mental health problems continued to receive care with AMHS.

Dieter Wolke, professor of developmental psychology and individual difference at the University of Warwick, said the findings highlighted the resilience of young people: “As a developmental psychologist, the results make sense. Clinicians may underestimate young people’s ability to adapt, learn to cope with challenges and master transitions.”

Regular community follow-up is ‘necessary’

A small subgroup of participants, however, reported worsening mental health after leaving CAMHS.

Swaran Singh, professor of social and community psychiatry at the University of Warwick, added: “Despite the positive findings, there remains the small subgroup of participants whose mental health deteriorated following CAHMS treatment. This highlights an area for further research, to investigate why this is the case and help GPs to identify these young people.

“It is important that GPs take young adults with renewed complaints seriously and refer them quickly to adult psychiatry; investments should be made to improve transition care for these young people specifically. Regular community follow-up is necessary to identify the minority of youth who showed deterioration in their mental health and need further psychological or psychiatric support.”

The research was led by academics at the Erasmus Medical Centre in Rotterdam. Suzanne Gerritsen, a research assistant at the centre said: “It is important to note that our findings do not provide insight into the struggle young people have finding the care they need, even though they may eventually find appropriate care. For example, waiting lists are still a big problem in many countries and navigating the pathway between CAMHS and AMHS could be improved for young people.”

The research is part of the MILESTONE study, a collaboration between the Erasmus MC Yulius in the Netherlands, Warwick University (Coventry, UK) and institutes in six other EU countries. It was funded by the European Commission (FP7).