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Table 2 Youth Recommendations for Improving Transition Experiences

From: Objectively terrifying”: a qualitative study of youth’s experiences of transitions out of child and adolescent mental health services at age 18

Recommendations for the Health Care System and Health Care Professionals
Partner with youth in transition planning• Offer youth more choice and control around transition-related decision-making (i.e., around parental involvement, AMHS referral, gender of AMHS clinician)
• Create individualized transition plans
Timing of transition is purposeful• Base transition timing on developmental and clinical readiness, not age
• Discussion transition with youth early, well in advance of transition date
• Ensure all stakeholders (i.e. youth, caregivers, CAMHS, AMHS, transition support workers/navigators) are involved early in the transition process
Ensure access to transition-related information• Provide details about what to expect during the transition process
• Provide information about what to expect from AMHS (i.e., differences in cost).
• Offer more ways for youth to get to know AMHS options and providers in advance (i.e. Print resources, “open house” to meet AMHS providers).
• Provide youth with access to information related to their plan of care, including any referrals that have been sent, key service contacts and next steps in their treatment plans, and ensure youth understand the information provided
Ensure relational continuity between CAMHS and AMHS• Connect youth to AMHS before CAMHS discharge
• Ensure primary CAMHS provider is involved in the transition process
• Provide youth with support and information to identify appropriate AMHS
• If youth are not referred directly to AMHS, provide the option to return to CAMHS for referral support later on, or the option to taper out of CAMHS services gradually.
• Have communication between CAMHS and AMHS clinicians and ensure overlapping CAMHS and AMHS care
• CAMHS should be responsible for following up to make sure that AMHS referral was appropriate and completed
Additional programmatic recommendations• Offer CAMHS transition support groups
• Create dedicated mental health services for transition aged youth
• Recognize the transition milestone (i.e., organize a celebration to mark CAMHS discharge)
Recommendations for Other Youth and Their Families
 • Manage expectations (be prepared for the process to confusing)
• Ask questions as soon as you have them
• Don’t hesitate to reach out to your personal support network during the transition process
• Recognize that it takes time to get connected to appropriate AMHS; start early