Transitions

This area of transitions is often overlooked. We understand that patients are sometimes transitioned from AMHS to OAMHS on account of their age, rather than their need. Protocols between services which clarifies the circumstances in which transitions should take place, across Wales, would be beneficial to patient care. 

In June 2020, we held focus groups with our child and adult psychiatry faculties to understand more about transitions between CAMHS and AMHS. Our focus groups have demonstrated to us that whilst there is guidance for transitions, it is not uniformly implemented, and disagreement and differences between services often prolong transitions unnecessarily. Our focus group agreed that a joint protocol between services would reduce friction in transitions and provide needed clarity and consensus for clinicians.

Our members who work with young people who have learning disabilities, have raised again that the transfer of young people with LD and sometimes comorbid ASD to specialist residential colleges can take place completely separately of local services. This process seems to defy principles of person-centred care and offers little consultation to the young person or their family about how or why this should take place. This process should be scrutinised to ensure that families are not made to feel distressed or disorientated. 

The transition between young offenders’ institutes and prison environments is a huge leap for many young people, and if improperly managed can lead to negative health outcomes for children and young people. Transitions guidance from the Youth Justice Board already exists in Wales, but we would like the Welsh Government to ensure its implementation as part of their strategic engagement with the Youth Justice Board and scrutinise the current transitions arrangements. 

Clinicians in Wales recognise the value of Individual Placement and Support models for helping patients with severe mental illness into competitive employment. There is a great deal of evidence in favour of IPS for improving employment opportunities for patients with a history of mental health issues.* IPS patients are twice as likely to gain employment and work for significantly longer, and these patients had fewer returns to hospital than patients not using IPS.