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Lost in transition? Professional perspectives on transitional mental health services for young people in Germany: a qualitative study

BACKGROUND: The transition of young patients from child and adolescent to adult mental health services often results in the interruption or termination of care. At this intersection, mental health professionals function as gatekeepers between systems, and their personal views on current clinical pra...

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Autores principales: Loos, Sabine, Walia, Naina, Becker, Thomas, Puschner, Bernd
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104012/
https://www.ncbi.nlm.nih.gov/pubmed/30134887
http://dx.doi.org/10.1186/s12913-018-3462-6
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author Loos, Sabine
Walia, Naina
Becker, Thomas
Puschner, Bernd
author_facet Loos, Sabine
Walia, Naina
Becker, Thomas
Puschner, Bernd
author_sort Loos, Sabine
collection PubMed
description BACKGROUND: The transition of young patients from child and adolescent to adult mental health services often results in the interruption or termination of care. At this intersection, mental health professionals function as gatekeepers between systems, and their personal views on current clinical practice can contribute to a broader understanding of procedures and help identify reasons for service gaps. This qualitative study investigated the views of mental health professionals on services for young people during the transition from child and adolescent to adult mental health care, as well as on factors which facilitate or hinder continuity of care. METHODS: Four group discussions with 24 mental health professionals with various backgrounds were conducted. Groups were audio-taped, transcribed verbatim and analyzed following the reconstructive approach of R. Bohnsack’s documentary method. RESULTS: A main theme and six subthemes emerged. Participants’ overall concern was an increasing lack of patient centeredness in care provision. They criticized the limited flexibility and time constraints of their work, which was held to be incompatible with the time-consuming process of engaging young patients in care and coping with their individual needs. A lack of adequate interprofessional exchange and networking was seen as resulting in a diffuse sense of responsibility and a lack of clarity for all involved parties. Participants focused on the adverse impact of neglecting developmental characteristics in care procedures for young patients and revealed personal issues they experienced in their work with young patients (e. g. personal difficulties with diagnosing). CONCLUSIONS: Mental health professionals at this transitional point face a number of complex tasks as well as limitations in terms of time and personal support. An emphasis should be placed on forming and maintaining partnerships within and between systems which could contribute significantly to relieving professionals’ workload. Furthermore, an open style of communication to engage young patients in care is essential. Strengthening communicative skills, improving knowledge about this life stage (especially when working in adult services), and promoting interprofessional encounters can help to develop new procedures in clinical practice. On higher system levels, heightened awareness of the need to reduce fragmentation of care and administrative barriers is needed. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12913-018-3462-6) contains supplementary material, which is available to authorized users.
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spelling pubmed-61040122018-08-30 Lost in transition? Professional perspectives on transitional mental health services for young people in Germany: a qualitative study Loos, Sabine Walia, Naina Becker, Thomas Puschner, Bernd BMC Health Serv Res Research Article BACKGROUND: The transition of young patients from child and adolescent to adult mental health services often results in the interruption or termination of care. At this intersection, mental health professionals function as gatekeepers between systems, and their personal views on current clinical practice can contribute to a broader understanding of procedures and help identify reasons for service gaps. This qualitative study investigated the views of mental health professionals on services for young people during the transition from child and adolescent to adult mental health care, as well as on factors which facilitate or hinder continuity of care. METHODS: Four group discussions with 24 mental health professionals with various backgrounds were conducted. Groups were audio-taped, transcribed verbatim and analyzed following the reconstructive approach of R. Bohnsack’s documentary method. RESULTS: A main theme and six subthemes emerged. Participants’ overall concern was an increasing lack of patient centeredness in care provision. They criticized the limited flexibility and time constraints of their work, which was held to be incompatible with the time-consuming process of engaging young patients in care and coping with their individual needs. A lack of adequate interprofessional exchange and networking was seen as resulting in a diffuse sense of responsibility and a lack of clarity for all involved parties. Participants focused on the adverse impact of neglecting developmental characteristics in care procedures for young patients and revealed personal issues they experienced in their work with young patients (e. g. personal difficulties with diagnosing). CONCLUSIONS: Mental health professionals at this transitional point face a number of complex tasks as well as limitations in terms of time and personal support. An emphasis should be placed on forming and maintaining partnerships within and between systems which could contribute significantly to relieving professionals’ workload. Furthermore, an open style of communication to engage young patients in care is essential. Strengthening communicative skills, improving knowledge about this life stage (especially when working in adult services), and promoting interprofessional encounters can help to develop new procedures in clinical practice. On higher system levels, heightened awareness of the need to reduce fragmentation of care and administrative barriers is needed. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12913-018-3462-6) contains supplementary material, which is available to authorized users. BioMed Central 2018-08-22 /pmc/articles/PMC6104012/ /pubmed/30134887 http://dx.doi.org/10.1186/s12913-018-3462-6 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Loos, Sabine
Walia, Naina
Becker, Thomas
Puschner, Bernd
Lost in transition? Professional perspectives on transitional mental health services for young people in Germany: a qualitative study
title Lost in transition? Professional perspectives on transitional mental health services for young people in Germany: a qualitative study
title_full Lost in transition? Professional perspectives on transitional mental health services for young people in Germany: a qualitative study
title_fullStr Lost in transition? Professional perspectives on transitional mental health services for young people in Germany: a qualitative study
title_full_unstemmed Lost in transition? Professional perspectives on transitional mental health services for young people in Germany: a qualitative study
title_short Lost in transition? Professional perspectives on transitional mental health services for young people in Germany: a qualitative study
title_sort lost in transition? professional perspectives on transitional mental health services for young people in germany: a qualitative study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104012/
https://www.ncbi.nlm.nih.gov/pubmed/30134887
http://dx.doi.org/10.1186/s12913-018-3462-6
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