A recent scoping review aimed to identify the key barriers and enablers in the transition from child and adolescent mental health services (CAMHS) to adult mental health services. The review, based on Arksey and O’Malley’s framework and the PRISMA extension for scoping reviews, analyzed 66 articles from an initial pool of 1,677 records, ultimately focusing on 10 studies. The research mainly addressed the experiences of young people with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), highlighting the challenges and successes in their transition to adult care.
Institutional Barriers Hinder Seamless Transition
The review found that institutional barriers played a more significant role than individual factors in disrupting care continuity. A primary issue was poor communication between CAMHS and adult mental health services, with unclear responsibilities around initiating and coordinating the transition. Fragmented processes, inconsistent eligibility criteria, and a lack of shared planning left many neurodivergent young people and their families unsure about what to expect, resulting in gaps in care.
Collaboration as a Key Enabler
The studies highlighted that positive transition experiences were closely tied to collaborative care. When clinicians adjusted their approach to meet the sensory, cognitive, and communication needs of neurodivergent youth, engagement improved, and anxiety around the transition decreased. Additionally, involving young people in decisions about their treatment plans—ensuring their preferences, priorities, and strengths were considered—was identified as an important enabler for a smoother transition to adult services.
Limited Exploration of Broader Influences and Young People’s Voices
Despite valuable insights, the review identified significant evidence gaps. Few studies examined the impact of community factors, such as schools and peer networks, or the role of policy-level influences like service funding and national guidelines on transitioning to adult care. Most studies relied on perspectives from clinicians or caregivers, with only half directly representing the voices of young people with autism or ADHD. This highlights a crucial gap in understanding the youth’s experience and the need for adolescent mental health teams to co-design transition pathways with neurodivergent youth.
Conclusion
The review underscores the need for institutional reforms to support smoother transitions for neurodivergent young people. It calls for a more collaborative approach between services and a greater emphasis on involving young people in shaping their care pathways. Additionally, addressing institutional barriers rather than focusing solely on individual needs will be crucial to improving the transition process.
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