Managing the link and strengthening transition from child to adult mental health Care in Europe (MILESTONE): background, rationale and methodology

• Published in: BMC psychiatry Vol. 18; no. 1; p. 167
• Main Authors: Tuomainen, H, Schulze, U, Warwick, J, Paul, M, Dieleman, G C, Franić, T, Madan, J, Maras, A, McNicholas, F, Purper-Ouakil, D, Santosh, P, Signorini, G, Street, C, Tremmery, S, Verhulst, F C, Wolke, D, Singh, S P
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 04-06-2018; BioMed Central; BMC
• Subjects: Adolescent; Adolescent Health Services - economics; Adolescent Health Services - trends; Adult; Adults; Age; Analysis; Child; Child & adolescent mental health; Child & adolescent psychiatry; Child and adolescent mental health services; Child development; Children & youth; Clinical trials; Cluster randomised controlled trial; Cohort analysis; Cohort Studies; Consortia; Continuity of care; Cost-Benefit Analysis - methods; Cost-Benefit Analysis - trends; Drug abuse; Ethics; Europe - epidemiology; Female; Health Personnel - economics; Health Personnel - trends; Health services; Health services research; Human health and pathology; Humans; Life Sciences; Literature reviews; Longitudinal cohort study; Male; Management; Mental disorders; Mental health; Mental Health - economics; Mental Health - trends; Mental health care; Mental Health Services - economics; Mental Health Services - trends; Multicenter Studies as Topic - economics; Multicenter Studies as Topic - methods; Patient Transfer - economics; Patient Transfer - methods; Patient Transfer - trends; Prospective Studies; Psychiatric services; Psychiatrics and mental health; Psychiatry; Psychosis; Randomized Controlled Trials as Topic - economics; Randomized Controlled Trials as Topic - methods; Study Protocol; Surveys and Questionnaires; Systematic Reviews as Topic; Teenagers; Transition; Europe; United Kingdom > UK; United States > US; Policy; Longitudinal cohort study; Child and adolescent mental health services; Cluster randomised controlled trial; Europe; Mental health; Transition; Professional training; Health services research; Youth mental health
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-018-1758-z

Transition from distinct Child and Adolescent Mental Health (CAMHS) to Adult Mental Health Services (AMHS) is beset with multitude of problems affecting continuity of care for young people with mental health needs. Transition-related discontinuity of care is a major health, socioeconomic and societal challenge globally. The overall aim of the Managing the Link and Strengthening Transition from Child to Adult Mental Health Care in Europe (MILESTONE) project (2014-19) is to improve transition from CAMHS to AMHS in diverse healthcare settings across Europe. MILESTONE focuses on current service provision in Europe, new transition-related measures, long term outcomes of young people leaving CAMHS, improving transitional care through 'managed transition', ethics of transitioning and the training of health care professionals.
Data will be collected via systematic literature reviews, pan-European surveys, and focus groups with service providers, users and carers, and members of youth advocacy and mental health advocacy groups. A prospective cohort study will be conducted with a nested cluster randomised controlled trial in eight European Union (EU) countries (Belgium, Croatia, France, Germany, Ireland, Italy, Netherlands, UK) involving over 1000 CAMHS users, their carers, and clinicians.
Improving transitional care can facilitate not only recovery but also mental health promotion and mental illness prevention for young people. MILESTONE will provide evidence of the organisational structures and processes influencing transition at the service interface across differing healthcare models in Europe and longitudinal outcomes for young people leaving CAMHS, solutions for improving transitional care in a cost-effective manner, training modules for clinicians, and commissioning and policy guidelines for service providers and policy makers.
"MILESTONE study" registration: ISRCTN ISRCTN83240263 Registered 23 July 2015; ClinicalTrials.gov NCT03013595 Registered 6 January 2017.