Psychiatric Disorder Clinical Trial
Official title:
Sustain and Reinforce the Transition From Child to Adult Mental Health Care in Switzerland : A Monocentric Nested Cohort Randomized Controlled Trial: The SORT Study.
Disruption of care during transition from child and adolescent mental health (CAMHS) to adult
mental health services (AMHS) may adversely affect the health and well-being of service
users. Indeed, transition-related discontinuity of care is a major health and societal
challenge today. Current evidences show that this transition is not always properly managed
and that improving the transition process can have a positive impact on the health and
wellbeing of young people. Nevertheless, data available are still inconsistent and only few
studies investigated possible models aimed at improving and operationalize the transition. At
present, no information concerning the transition in the Geneva Canton is available.
According to this lack of evidence, the current study aims at: 1) mapping the CAMHS/AMHS
interface; 2) evaluating the longitudinal course and outcomes of adolescents approaching the
transition boundary (TB) of their CAMHS; 3) determining the effectiveness of an experimental
model of managed transition in improving outcomes, compared with usual care; 4) comparing
these results with those of the EU funded MILESTONE study from several other European
countries.
The investigators will recruit all patients aged ≥ 16 years and 6 months from the Geneva
Canton in charge at CAMHS and they will follow them for up to 24 months. CAMHS will be
instructed to provide all their service users at the time of transition either usual care or
a novel service called "Managed Transition", which will include the use of a new decision
support tool, the Transition Readiness and Appropriateness Measure (TRAM). A nested cohort
Randomised Controlled Trial (ncRCT) design will be applied to divide patients into the two
groups. The health and wellbeing of the young people will be assessed at baseline and then
followed-up for 24 months to see whether they transition to AMHS or are discharged or
referred to some other service. The investigators will then evaluate what impact the
different transition experiences have on young people's health and wellbeing, and whether the
process of Managed Transition has any benefits as compared to usual care.
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