Cappelli M, Davidson S, Racek J, et al. Transitioning youth into adult mental health and addiction services: An outcomes evaluation of the youth transition project. Journal of Behavioral Health Services Research. 2016;43(4):597-610. doi:10.1007/s11414-014-9440-9.
NPM: 12: Transition
Intervention Components (click on component to see a list of all articles that use that intervention): Planning for Transition, Pediatric to Adult Transfer Assistance, Care Coordination, PROVIDER/PRACTICE
Intervention Results:Evaluation of the shared management model for youth transitions showed positive results in shortening transition times, with decreases seen over each subsequent program year. However, mixed results were seen in the distribution of youth who transitioned, with close to 60% of youth being seen by adult providers while the rest remained on waitlists or canceled services. The results demonstrate that the sample of youth enrolled in the program were in high need of services, fulfilling the objective of the Youth Transition Project in identifying an appropriate group of youth in need of transition. The Youth Transition Project also achieved the objectives of providing counseling services to youth and coordinating their transition to AMHS. Of the 215 young people seen by the transitions coordinator over an 18-month period, 127 completed their transition and were seen by an AMHS provider; 41 had yet to transition and remained on a waitlist for AMHS; and 47 youth canceled services (declined further services, did not return phone calls, or moved away) and did not complete their transition: 16 canceled services after being seen by the coordinator while 31 canceled after being referred to AMHS. Youth who transitioned reported being more psychologically distressed and displayed more significant internalizing disorders. These youth may have shown a greater need for immediate treatment or were potentially given priority over those displaying a lesser degree of urgency. It took an average of 100 days for youth to transition to AMHS. significant internalizing disorders. These youth may have shown a greater need for immediate treatment or were potentially given priority over those displaying a lesser degree of urgency. It took an average of 100 days for youth to transition to AMHS. Chi-square tests revealed that a significantly greater proportion of transitioned youth had a greater number of prior emergency department visits, and that canceled youth scored significantly higher on the ANSA’s measure of antisocial behavior. Also, a greater proportion of canceled youth were diagnosed with Anxiety Disorder
Transition times for youth significantly differed across AMHS provider, and they were significantly longer for youth referred to project-partner AMHS than for youth referred to non-project-partner AMHS. The distribution of youth seen by project-partner providers was as follows: general hospitals (English: 15.0%; n=19; French: 4.7%; n=6); mental health centers (38.6%; n=49); community youth service agencies (6.3%; n=8), and substance abuse treatment centers (3.1%; n=4); and non-project partners (32.3%; n=41). Significant differences were also found between project partners and non-project partners for youth’s reports on questionnaire measures. On the OCANSelf assessment, youth seen by project partners reported significantly more unmet needs than those seen by non-project partners on items related to time spent on activities, physical health, psychological distress, and intimate relationships.
Youth referred to the program presented with various mental health disorders and other problems, including anxiety (71%), mood disorders (62%), substance-related disorders (21%), and disorders usually first diagnosed in infancy, childhood, or adolescence (~40%). The majority of youth were currently on medication and had other health conditions aside from their mental illness. At the time of initial referral, 78.7% (n=133) of youth lived with their parents, 6.5% (n=11) in shelters or were homeless, 5.9% (n=10) on their own, 4.1% (n=7) in group homes, 2.4% (n=4) with relatives or friends, 1.8% (n=3) with a grandparent, 0.6% in foster homes (n=1), and 14.1% (n=31) of youth were involved with a child welfare agency.