Topic: Children, Mental Health
Conditions
Interventions
Intervention arm: The model of managed transition includes:
1. The completion of the “Transition Readiness and Appropriateness Measure” (TRAM, a standardized structured assessment) prior to the trans
Sponsors
University of Warwick
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Young person inclusion: 1. Provides valid written informed consent, or assent, if below the legal age of consent 2. If age is within 1 year of reaching the transition boundary of their CAMHS during the trial recruitment period and (added 23/01/2017) in exceptional cases, not more than 3 months older than the transition boundary, if a decision about transition has not yet been made 3. Has a mental disorder defined by DSM-IV-TR, DSM-5 or ICD 10/11, or is under the regular care of CAMHS (if not yet diagnosed) 4. Has an IQ = 70 as ascertained by previous standardised assessment or diagnosed by clinician, or no indication of intellectual impairment Parent/carer inclusion: 1. Only one parent/carer per young person can be recruited into the study, the aim being to engage the same individual throughout the study. If the latter is not possible, then the aim is to involve another parent/carer 2. If the young person doesn’t live with his/her biological parent/s, then his/her carer will be involved. A carer may be the legal guardian or a partner or an older adult sibling, or another individual living with and/or providing regular support to the young person 3. For young people under the legal age of consent, the parent/carer has to be the legal guardian of the young person 4. Young person consents to parent/carer participation 5. Parent/carer provides a valid written informed consent Clinician/care provider inclusion: 1. Is responsible for the main care for young person at CAMHS (and AMHS or other relevant service provider, if referral is made) 2. Provides a valid written informed consent
Exclusion criteria
Exclusion criteria: Young person exclusion: 1. Does not provide valid written informed consent, or assent, if below the legal age of consent 2. Is younger than a year before the transition boundary of their CAMHS 3. Has intellectual impairment (IQ <70) as ascertained by previous standardised assessment or diagnosed by clinician (if no data on intellectual functioning are available [because it has never been assessed] then care coordinators will be asked to make a clinical judgement on intellectual impairment before baseline assessment takes place) 4. If not able to (or expected not to be able to) complete the questionnaires due to severe physical disabilities or language problems, even with assistance from family members or research assistant 5. Service user in a secure forensic institution Parent or carer refusal or inability to participate him/herself in assessments may prevent the participation of the service user, yet this will depend on the individual country’s legal and ethical situation. In the UK, young people over the age of 16 will be able to take part even if their parent/carer does not take part. Parent/carer exclusion: 1. A parent/carer who does not live with and/or provide regular support to young person 2. Young person does not provide consent for parent/carer participation 3. Parent/carer does not provide a valid written consent 4. If not able to (or expected not to be able to) complete the questionnaires due to severe physical disabilities or language problems, even with assistance from family members or research assistant Clinician/care provider exclusion: 1. Does not provide care for young person, or only provides intermittent care at CAMHS (and AMHS or other relevant service provider, if referral is made) 2. Does not provide a valid written informed consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Current primary outcome measures as of 23/01/2017: Mental health status (need for care), measured by the use of the clinician’s version of the Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA) at 15 months. The measure will be completed by a trained MILESTONE research assistant taking into account all available sources of information (including the young person, parent/carer, relevant clinician and the medical records) to ensure accuracy of data. Previous primary outcome measures: Mental health status (need for care), measured by the use of the clinician’s version of the Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA) at baseline, 9, 15, and 24 months. The measure will be completed by a trained MILESTONE research assistant taking into account all available sources of information (including the young person, parent/carer, relevant clinician and the medical records) to ensure accuracy of data. | — |
Secondary
| Measure | Time frame |
|---|---|
| Current secondary outcome measures as of 20/06/2017: 1. Self-rated (i.e. completed by young person) mental health status (need for care), on Health of the Nation Outcome Scale for Children and Adolescents (HONOSCA) at baseline, 9, 15, and 24 months 2. Transition outcome, assessed by the Transition Related Outcome Measure (TROM) (young person, parent/carer, clinician) at 9, 15, and 24 months 3. Self-reported and parent/carer reported psychopathology, assessed by The Development and Well-being Assessment (DAWBA) (Young person, parent/carer) at baseline and 24 months and clinical diagnosis (clinician) at baseline, 9, 15 and 24 months 4. Emotional and behavioural problems, assessed by the ASEBA Youth Self Report (YSR)/Adult Self Report (ASR) questionnaires (young person) and CBCL/ABCL questionnaires (parent/carer) at baseline, 9, 15, and 24 months 5. Illness severity, assessed by Clinical Global Impression Severity scale (CGIseverity) (clinician) at baseline, 9, 15, and 24 months 6. Quality of life assessed by WHOQOLBREF (young person) at baseline, 15 and 24 months 7. Independent behaviour, assessed by Independent Behaviour During Consultation Scale (IBDCS) (young person) at baseline, 9, 15, and 24 months, if young person is a current service user 8. Illness perception, assessed by the Brief Illness Perception Questionnaire (BIPQ) (young person) at baseline and 24 months 9. Barriers to care, assessed by Barriers to Care (BtC) checklist (young person) at 9, 15, and 24 months, if young person is no longer a service user 10. Transition experience and readiness assessed by OYOF-TES – Transition Experience Scale (young person, parent/carer) completed at 9, 15 or 24 months, completed only once at the first assessment after transition 11. Adult functioning, assessed by Specific Levels of Functioning Scale (SLOF) (parent/carer) at baseline and 24 months. 12. Cost-effectiveness, assessed by EQ-5D-5L (young person) at baseline, 9, 15, and 24 months 13. Service use assessed by | — |
Countries
Belgium, Croatia, England, France, Germany, Ireland, Italy, Netherlands, United Kingdom
Contacts
Public ContactHelena Tuomainen
Outcome results
None listed