Evidence:

The TRACK study evaluated transitions from youth to adult mental health services in the United Kingdom. It identified organizational factors that interfere with effective transitions, such as ineffective implementation of existing protocols, and lack of collaboration and communication between sectors, and provided recommendations on how services can best be organized and delivered to support youth transitions. It identified four components for high quality transitions:

Information continuity: effective information transfer.
Relational continuity: a period of parallel care and joint working between services.
Cross boundary and team continuity: transition planning with at least one meeting that includes the young person, parent or caregiver, youth service provider, adult service provider, and other services. Care continuity: continued connections between the youth and adult service providers after the transition is complete.

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Transitioning into adulthood can be a challenging time for any youth, but these years are especially difficult for youth with mental health and addiction challenges. In London-Middlesex, all too often transition-aged youth (aged 16-24) have difficulty transitioning into adult mental health and addiction services, due to a lack of inter-connectivity and unclear service pathways – causing them to miss out on crucial services and supports.

What are we doing about it?

In December 2015, a diverse group of community partners in London-Middlesex came together for a “Moving on Mental Health Collective Impact Summit.” Community partners agreed that better transition pathways into the right adult mental health and addiction services were needed, and that they must be coordinated, clear and efficient.

The Transitional Age Protocol Community Implementation Team (TAPCIT) was first established, and then a TAPCIT working group was convened to use an evidence-based approach to improving youth transitions. The working group, with 15 members representing different mental health and addiction agencies in London-Middlesex, chose Vanier Children’s Services, the Transitional Age Project at London Health Science Centre, and CAMH to co-chair the working group.

The working group learned that three other regions in Ontario are already confronting similar service transition problems by adapting findings from a large U.K. study on effective transition pathways. The working group is now developing a youth transition protocol tailored to London-Middlesex that uses the UK study and the implementation experiences of the other regions in Ontario. The group is also engaging and consulting with youth addiction and mental health agencies to help with this work.

The group aims to improve:

transfers of client information;
communication between agencies; and
collaboration among the people involved (including youth, youth agencies, and adult agencies)

Project Implementation Progress

Exploration
Installation
Initial Implementation
Full Implementation

?What's this?

Exploration

To develop a youth transition protocol, the TAPCIT Working Group decided it needed information about the current state of transitions from youth to adult service in the region. The group developed a map of current mental health and addiction services for transitional age youth in the London-Middlesex (figure 1). It then identified 12 agencies (highlighted in figure 1) that were critical to study in order to gain greater insight into current service transition practices. In fall 2017, the working group gathered extensive information from these 12 agencies through surveys and interviews.

Installation

In October 2017, TAPCIT held an event called the TAPCIT Design Studio to co-create the protocol materials with youth. This event was led by staff at mindyourmind, a provincial agency that works with young people to co-develop interactive tools and innovative resources. Eight youth, between 16-25 years old and of different genders, participated in the two-day event. They described their own personal experiences preparing for and transitioning to adult services. On the second day, the youth reviewed materials developed in other jurisdictions and recommended content and designs for the TAPCIT protocol.

The TAPCIT Working Group, with the help of mindyourmind staff, is now developing the transitional age youth (TAY) protocol and accompanying resources for providers and youth.

Initial Implementation

When a draft protocol and accompanying resources have been drafted, they will be pilot tested in the community. The TAPCIT Working Group will identify a small number of agencies as protocol pilot sites and will develop tailored agency-level action plans to assist with implementation and evaluation.

Recently, Oxford and Elgin counties have expressed interest in joining the development and implementation of this protocol.

Full Implementation

The project has not yet reached this implementation stage.

Who is involved?

TAPCIT aims to be inclusive. As a result, its members reflect a broad range of sectors and organizations, including:

children’s mental health
adult mental health
Catholic and public school boards
youth justice
hospital inpatient and ambulatory service
Western University
youth and adult addiction services
community counseling services

For more information, please contact:

Beth Powell, Implementation Specialist

London, Ontario
519-858-5158 ext. 20082
beth.powell@camh.ca

CAMH PSSP

Implementing a Youth Transition Protocol in London-Middlesex

What is the system challenge?