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Table 1 Included Articles (18 articles representing 14 studies)

From: Youth experiences of transition from child mental health services to adult mental health services: a qualitative thematic synthesis

Study N of Service-Users Sample/Setting Methods Diagnosis Age Country CASP Score (/10)
1. Beresford et al. [40] 4 Young people with high functioning autism on cusp of leaving school or who were young adults. Recruited from youth who responded to the family survey (done at selected local health trusts). Interviews: topic guides with use of written chart as communication aid.
Parents and professionals also interviewed.
Thematic analysis.
High-functioning autism or Asperger’s syndrome. 18–19 years. United Kingdom 8
2. Cheak-Zamora & Teti [42] 13 Convenience sampling from clinics seeing youth with ASD. Semi-structured focus groups.
Caregivers also interviewed.
Thematic analysis.
Autism Spectrum Disorder (with at least minimal verbal ability). 15–25 years United States 9
3. Delman & Jones [39] 24 Youth who received publicly financed MH services as adolescents. Recruited through flyer advertising with a $25 incentive to organizations frequented by young people. Semi-structured interviews.
Additional Likert scale and “yes” or “no” items.
Thematic analysis, phenomenological perspective.
No diagnosis specified. 18–26 years United States 5
4a. Hovish et al. [24] 11 Young people across six centers who reached the transition boundary between CAMHS and AMHS. Subject to a positive response from the CAMHS or AMHS clinician, young people invited to participate in an interview. Semi-structured interviews.
Parents and professionals also interviewed.
Thematic analysis of each case (comprising data from multiple sources, as above).
Diagnoses included: Psychotic disorders, MDD, eating disorder, BAD, chronic suicidal ideation, Asperger’s, anxiety, and OCD. Not specified. United Kingdom 6
4b. Singh [33] Not stated. Sub-sample of service-users, carers and their care coordinators. Recruitment sources not specified. Interviews using topic guides.
Parents and professionals also interviewed.
Analytic method not described.
Diagnosis not specified. Not specified. United Kingdom 4
4c. Singh et al. [6] 11 Subsample of service users who had completed transition from CAMHS to AMHS. Semi- structured interviews.
Parents and care-coordinators also interviewed.
Constant comparative method.
Diagnosis not specified. Not specified. United Kingdom 7
5. Hyde [41] 20 Adolescents in out-of-home placements. Recruitment strategy not described. Interviews (not described).
Professionals who work with foster youth (not necessarily the included youth) also interviewed.
Analytic method not described.
No diagnosis specified. 16–18 years. United States 3
6. Jivanjee & Kruzich [23] 16 Youth referred by MH professionals. Recruitment from local mental health agencies, youth advocacy/support groups, colleges, alternative schools, and youth employment organizations. Focus groups (not described).
Parents also interviewed.
Thematic analysis. Constant comparative method.
Diagnoses included: BAD, MDD, LD, ADHD, behavioral disorder, OCD, PTSD. 17–23 years. United States 8
7. Klodnick et al. [46] 16 (pre-transition)
13 (post-transition)
Purposive sample of young people who planned to exit the therapeutically-oriented transitional living program within one year. Semi-structured interviews.
Grounded Theory, negative case analysis.
Diagnoses included: BAD I, schizophrenia or schizoaffective disorder or MDD. 20.1 years (pre-transition average);
23.1 years (post-transition average)
United States 9
8. Lamont et al. [38] 10 Each local authority asked to identify 4 care leavers willing to act as case studies. Local authorities asked to select young people who had been in care aged 16–21 (or 24 if still in full-time education), and who had mental health needs. Interviews using topic guides.
Professionals also interviewed.
Analytic method not described.
Diagnoses included: MDD, suicidal ideation, PTSD, BAD, anxiety, substance use, psychotic disorders, self-esteem issues, behavioral issues. 16–23 years. United Kingdom 4
9a. Lindgren [37] 3 pre-transition;
11 post-transition
Recruited if between 18 to 25 years old, having experiences of care at both child and adolescent psychiatry (CAP) and General Psychiatry (GenP). Invited to participate by therapist at CAP. Interview guide with open-ended questions.
Family members also interviewed.
Grounded theory.
Diagnoses included: Anorexia, anxiety, MDD, suicidal ideation, ADHD, Asperger’s and drug addiction. 18 years (pre-transition);
18–26 years (post-transition)
Sweden 10
9b. Lindgren et al. [36] 3 Participants recruited when terminating care at CAP and referred to GenP. Invited to participate by therapist at CAP. Interviews (not described).
Parents and professionals also interviewed.
Grounded theory.
Diagnosis not specified. Not specified. Sweden 9
10a. Munson et al. [35] 60 Diagnosed with a mood disorder during childhood, used Medicaid-funded MH services, and used at least one additional public system of care. Recruited through study ads at agencies serving former system youth and in community. Semi-structured interviews.
Additionally, survey Questionnaires: SACA, CESD, CTQ.
Immersion/crystallization. Grounded theory.
Mood disorder. 18–25 years. United States 10
10b. Munson et al. [34] 60 Diagnosed with a mood disorder during childhood, used Medicaid-funded MH services, and used at least one additional public system of care. Participants had to be living in the community. Semi-structured interviews.
Additionally, survey Questionnaires: SACA, CESD, CTQ.
Immersion/crystallization. Grounded theory.
Mood disorder. 18–25 years. United States 10
11. O’Loughlin [45] 6 Youth with eating disorder who have transitioned from CAMHS to AMHS in the past 5 years. Currently receiving treatment for an eating disorder or have undergone a planned discharge from adult services. Semi-structured interviews.
Parents (n = 5) were also interviewed.
Interpretative phenomenological analysis.
Eating disorders (5 Anorexia Nervosa and 1 Bulimia Nervosa). 18–21 years. United Kingdom 10
12. Sakai et al. [43] 28 History of MH service use while in foster care and use of at least one MH service after aging out. Purposive sampling from a community center assisting youth transitioning to adulthood from foster care. Recruited through standardized scripts by on-site case managers. Semi-structured focus groups.
Grounded Theory, coding consensus co-occurrence and comparison method.
No diagnosis specified. 18–27 years. United States 9
13. Swift et al. [44] 10 Young people aged 17-years and over with a diagnosis of ADHD or psychotic illness. Participants were identified though the young person’s CAMHS clinician. Semi-structured interviews.
Thematic analysis.
Diagnosis of ADHD or psychotic illness. 17 years and over United Kingdom 8
14. Wheatley et al. [47] 8 All females who had completed a transition from the adolescent medium secure services to the adult female secure services (medium and low secure) within an 18 month period. Semi-structured interviews.
Iterative inductive content analysis.
Diagnoses included: forensic history, emotionally unstable personality disorder, paranoid schizophrenia, post-traumatic stress disorder, attention deficit disorder, substance misuse, self-injurious behavior, history of childhood abuse. Not specified. United Kingdom 6