Most young people who leave mental health services may not see a worsening of symptoms

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

The study, published today in The Lancet Psychiatry, involved scientists from Universities across Europe, including the University of Warwick and Erasmus Medical Center, Rotterdam.

It followed more than 700 young people, with an average age of 17.5 years, and repeated assessments on their mental health symptoms and treatment over a two-year period in which they transitioned from CAMHS to AMHS, stayed in CAMHS, or left mental health care altogether.

Although approximately half of young people reaching the upper age limit of their CAMHS stop using mental health services, this was not associated with a deterioration in their mental health. The research also revealed that those with more severe mental health problems continued to receive care with AMHS.

This is positive news, according to Professor Dieter Wolke from the University of Warwick, and highlights the resilience of young people. He said, "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."

Professor Swaran Singh, chief investigator on this MILESTONE project, from 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."

Researchers based in the Erasmus MC in Rotterdam who led the study, Suzanne Gerritsen and child and adolescent psychiatrist Gwen Dieleman, are keen to highlight the journey it takes to receive the care they need.

Suzanne comments, "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."