Why this guide is needed

It is now understood that adolescence to early adulthood is the peak age of onset for mental ill-health and the period when there is a need for initial care¹. Poor mental health is closely related to many other health and social concerns for young people, including educational achievements, employment, relationships and substance use².

Treating poor mental health early improves chances of recovery and reduces the likelihood of severe and enduring illness and all its associated poor health and social problems extending further into adult life³.

Early intervention and support for young people with mental health problems is, therefore, an issue of  considerable significance for the UK’s society, both in terms of public health and social wellbeing.

Young people with mental health needs have a right to choice regarding the support they receive, but there remain a number of significant barriers which regularly prevent this from happening.

We outline some of these barriers below.

Child and Adolescent Mental Health Services

Child and Adolescent Mental Health Services (CAMHS) are generally able to support young people with mental health problems up to the age of between 16 and 19 years, depending on the service and individual circumstances. There are a few examples of CAMHS being offered up to the age of 21, particularly with  young people leaving care, but these are currently rare ⁴.

In 2011, the government launched the Children and Young People’s IAPT (Improving Access to Psychological  Therapies) programme, intended to  improve existing CAMHS services.However, accessing support from CAMHS services remains problematic for many, causing the Health Select Committee to launch an inquiry into the current state of CAMHS in 2014⁵. Evidence given to the Inquiry suggests that need currently exceeds provision, and that, in order for young people to receive adequate support, CAMHS cannot be expected to provide for the whole solution.

More creative responses, which include primary care interventions, youth counselling services, online
interventions, and programmes delivered by youth agencies and other voluntary sector providers, are
therefore required⁶.

Transitions

Young people requiring ongoing support as they enter adulthood may, at some point, transition to adult
services, a process which is often fraught with difficulties (see Box 1). The Department of Health admits
that the problem with transitioning has not been resolved and that many young people ‘fall off the cliff edge’ at age 18⁷ This can result in young  people disengaging with mental healthservices despite their continuing need.

Adult Mental Health Services

When young people do reach adult mental health services (AMHS), they often find that they are not ‘young person friendly’ or do not reflect the specific needs of the 16–25 age group. Young people are typically expected to fit into adult services, rather than adult services being modelled to appropriately engage and support 16–25 year olds.

Furthermore, the fear of being  stigmatised for having a mental health problem is also a major factor
in young people’s decisions not to access help from mainstream,  traditional services⁸. These issues can mean that young people’s mental  health needs often go unsupported.The Right Here programme developed a range of effective approaches to address the issues and barriers to mental health support for those aged 16–25.

This included working with young  people, youth charities and mental health agencies across four sites
in Brighton and Hove, Fermanagh, Newham, and Sheffield using a unique combination of youth participation and co-design, prevention, early intervention, resilience building and anti-stigma activities.

This guide builds on the experience of the Right Here programme in terms of developing appropriate mental health  services for young people through CAMHS transitions and AMHS, in both the statutory and voluntary sectors.  In this guide, we summarise some of the key points learnt from the Right
Here experience which can point to the future direction of young people’s mental health services across the UK.

Some Common Transition Frustrations⁹

1. Not involving young people, in advance, in planning for their transition to adult services can cause anxiety and stress.
2. Higher thresholds for adult mental health services can mean that some young people may not be immediately eligible for ongoing support. They may then go on to meet such thresholds later if their unmet mental health needs have resulted in deteriorating health.
3. Waiting lists for adult services  can result in gaps and pauses in support.
4. Bureaucratic referral and assessment processes can be off-putting and give a bad first impression of the services.

Sub Section test

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