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Transition Psychiatry – Bridging the Gap Between Child/Adolescent and Adult Mental Health Care

09 January 2020

Wolfgang Gaebel

 

Adult mental health care in many countries across Europe and beyond is still organized around institution-based  instead of community-based services (1, 2) - not integrated but fragmented on various levels from service provision to organization and funding. These are obstacles for implementing patient-oriented and evidence-based treatment and care.

This situation is most prevalent in the field of child- and adolescent psychiatry and its separation from adult services (3, 4). Many severe mental disorders are beginning early in life expanding into adulthood and later ages. A service border between age groups is arbitrary  and adverse to fulfil the needs of either group of patients across the lifespan to allow for a smooth transition along personal developmental needs and course of illness from early recognition to prevention and intervention.

Ongoing mental health care reforms across countries are aiming to bridge the gap between child/adolescent and adult mental health services by restructuring and connecting services to meet age- and illness-specific needs for young people at risk for or with manifest mental illness. Even information on health care coverage in the early age ranges is still lacking in many countries and needs to be made available for planning and monitoring health care reforms  (5). Early recognition and intervention services for young people with psychosis proneness are examples of successful youth mental health reforms transforming mental health services for this age group  (6).

In conclusion, policies, action planning, guidelines and guidance are needed to be jointly implemented across disciplinary borders and diagnostic categories including relevant stakeholders to bridge service gaps for better mental health of future generations (7, 8, 9). 

References: 

1 WHO European Mental Health Action Plan, 2013
2 European Joint Action on Mental Health and Well-being, 2013
3 Signorini et al., 2017
4 Signorini et al., 2018
5 Gaebel et al., submitted (2019)
6 Malla et al., 2016
7 Banaschewski et al, 2019
8 DGPPN, 2016
9 DGPPN, 2019

Address for correspondence:

Univ.-Prof. Dr. med. Wolfgang Gaebel
Past President EPA
WHO Collaborating Centre on Quality Assurance and Empowerment in Mental Health
LVR-Klinikum Düsseldorf
Heinrich-Heine-University Düsseldorf
Bergische Landstraße 2
D-40629 Düsseldorf
Tel. 0211/922-2752
Fax 0211/922-2031
wolfgang.gaebel@lvr.de
wolfgang.gaebel@uni-duesseldorf.de

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