Mind the gap

Psychiatrists have been urged to take special care that young patients with mental illness are not lost from the health care system as they make the transition from child and adolescent services to adult services. A recent review of the sparse research on the subject noted that poor transition leads to a disruption in continuity of care and disengagement from services, which almost certainly will lead to poor clinical outcomes. Socially isolated adolescents are at the greatest risk of dropping out of care, but also most vulnerable to a deterioration in their mental health. “Adolescence is a developmental stage, rather than something defined strictly by age,” the review stated. “However, services and policies are often demarcated by rigid age boundaries.” Ideally, services should allow for some flexibility in deciding when a young patient is mature enough to make the move to the adult health system. In practice, though, busy teams struggling with complex case loads often used arbitrary age boundaries as a way of managing their resources. More research was needed to define the scope of the problem and identify some solutions. What do you think?...