title: Transition to adult mental health services for young people with attention deficit/hyperactivity disorder (ADHD): a qualitative analysis of their experiences.
abstract: BACKGROUND
  There is little research on the process of transition between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS). More recently, there is growing recognition that Attention Deficit/Hyperactivity Disorder (ADHD) may persist into adulthood requiring services beyond age 18. However, despite National Institute for Health and Clinical Excellence (NICE) Guidance which recommends specialist services for adults with ADHD, there is currently a lack of such services in the UK. The aim of the current study is to explore the experiences of young people with ADHD during transition from CAMHS to AMHS.
  
  
  METHODS
  Semi-structured qualitative interviews with ADHD patients accessing CAMHS clinics in Nottinghamshire were analysed using thematic analysis.
  
  
  RESULTS
  Ten semi-structured interviews were transcribed and analysed. We found that patients' relationships with their clinician were a key factor in both their reported experience of CAMHS and the transition process. Perceived responsibility of care was also pivotal in how the transition process was viewed. Nature and severity of problems and patients expectations of adult services were also contributing factors in the transition process. The need for continued parental support was openly accepted and thought to be required by the majority of young people with ADHD during transition.
  
  
  CONCLUSIONS
  Timely preparation, joint working, good clinician relationships and parental support serve to facilitate the process of transition for young people with ADHD. Nature and severity of problems are perceived to impede or facilitate transition, with predominantly more 'complex presentations' with associated mental health problems more familiar to AMHS (e.g. self-harm, depression) making for smoother transitions to adult services. Transitions to AMHS were more difficult when ADHD was viewed as the main or sole clinical problem. Further exploration of young people's experiences of transition and their engagement with and experience of adult services is required to provide an overall picture of facilitators to successful transition and integration into adult services.
authors.affiliation: Child and Adolescent Mental Health Services, Nottinghamshire Healthcare NHS Trust, Nottingham, United Kingdom. Katie.Swift@nottshc.nhs.uk
authors.forename: Katie D
authors.initials: KD
authors.lastname: Swift
authors.forename: Charlotte L
authors.initials: CL
authors.lastname: Hall
authors.forename: Vic
authors.initials: V
authors.lastname: Marimuttu
authors.forename: Lucy
authors.initials: L
authors.lastname: Redstone
authors.forename: Kapil
authors.initials: K
authors.lastname: Sayal
authors.forename: Chris
authors.initials: C
authors.lastname: Hollis
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008605:Mental Health Services; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012720:Severity of Illness Index; D060305:Transition to Adult Care / Q000706:statistics & numerical data