Livanou, Maria (2018) Transition of care among young offenders with ongoing mental health problems in England : young offenders in transition. (PhD thesis), Warwick University, .

Abstract

Background: previous research has shown that transitions from child and adolescent mental health services to adult services are highly problematic for young people in the UK. The needs of young people during transition periods increase and care provision resources are limited. Objectives: this research study aimed to examine the transition processes, policies and outcomes across all six nationally commissioned medium secure adolescent units in England. Methods: this research study included four interlinked phases within a sequential exploratory mixed methods design that examined transition of care from forensic child and adolescent mental health services (FCAMHS) among young offenders with mental health problems. The first phase looked at the prevalence of mental disorders among young offenders with the use of a meta-analysis. A mapping exercise identified young people approaching 18 years within a six-month period. Thirty-two retrospective cases notes were reviewed looking at discharged patients the preceding year. Fifty-two face-to-face semi-structured interviews were carried out to explore healthcare providers’, service users’ and their families’ transition experiences. Results: the mapping exercise and case note review findings highlight the complexity of needs in this group. Subthemes elicited from the interviews with healthcare professionals included transitional delays and young people’s lack of readiness to move onto adult services. Majority of the young people reported that they did not know the transition date whilst families described transitions as anxiety-provoking events. Conclusions: this research study added an original contribution to the literature based on empirical findings that inform transition policy and clinical practice. This is the first prospective study that followed up young people across England to identify transition outcomes nationally. Policy makers need to aim for flexible age criteria to facilitate service transformation that is person-centred avoiding the traditional one-size-fits-all models of care.

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