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Mapping Child and Adolescent Mental Health Services and the Interface During Transition to Adult Services in Six Swiss Cantons

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Rationale: Transition in psychiatry refers to the period where young people transit from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). Discontinuity of care during this period is well-documented but little is known about provisions and transition characteristics and policies across Switzerland. The aim of this article is to describe the architecture of public mental health providers in Switzerland and compare it to EU countries.

Method: Two mapping surveys, developed previously for European countries, were adapted and sent to cantonal experts: the adapted European CAMHS Mapping Questionnaire (ECM-Q) assessing the architecture and functioning of CAMHS and the adapted Standardized Assessment Tool for Mental Health Transition (SATMeHT) to map CAMHS-AMHS interface.

Results: Data were gathered from six cantons. Activity data and transition policies were comparable between Swiss regions and European countries. The percentage of young people below 19 years who were in care was above 2% in every responding canton with a higher proportion of boys than girls for patients <12 years of age. The transition occurred at the age of 18 years, civil majority, in each canton, and between 0 and 24% (3/7) and 25% and 49% (4/7) of young people were expected to transition. One canton (1/7) benefitted from written guidelines, at the CAMHS level only, regarding transition but none had guidelines for mapping CAMHS/AMHS interface even at the regional level.

Conclusion: Despite the availability of resources and even if the possibilities of access to care are on average higher than in many European countries, issues regarding transition remain comparable in six Swiss cantons when compared to Europe. Meaning that beyond resources, it is the coordination between services that needs to be worked on. Importantly, implementing those changes would not require investing financial resources but rather working on the coordination between existing teams.

OriginalsprogEngelsk
Artikelnummer814147
TidsskriftFrontiers in Psychiatry
Vol/bind13
ISSN1664-0640
DOI
StatusUdgivet - 9 maj 2022
Eksternt udgivetJa

Bibliografisk note

Funding Information:
All cantons displayed different financing proportions for mental health care. All benefitted, at different levels, from the participation of the Swiss Federal Law on Compulsory Health Care (LAMaL), which is the mandatory health care insurance for all people living in Switzerland. It is offered by private insurance companies and represents the minimal standard for health care insurance. Its contribution to mental care financing ranged between 25 and 80%. Most of the remaining financing was supported by tax-based cantonal government funding (from 40% up to 70%, one canton did not benefit from it; for more detailed information, please see ).

Funding Information:
FD was supported by the National Institute for Health Research (NIHR) Research Professorship to Professor Andrea Cipriani (grant RP-2017-08-ST2-006) and by the NIHR Oxford Health Biomedical Research Centre (grant BRC-1215-20005).

Funding Information:
We would like to acknowledge the Fondation Privée des HUG for funding the SORT project. This article would also not have been possible without the valuable help and time from experts in the cantons who participated in the study: Dr. Evelyn Herbrecht (for Basel-City), Prof. Laurent Holzer (for Fribourg), Prof. Hélène Beutler (for Neuchatel), Dr. Marie-Pierre Pont, and Dr. Fabienne Grange (for Valais), and the help of the Swiss Society for Child and Adolescent Psychiatry and Psychotherapy. We acknowledge the contribution of the Clinical Research Center, Geneva University Hospitals and Faculty of Medicine, Geneva. We also acknowledge the MILESTONE Consortium for their support and development of the tools used in this article.

Publisher Copyright:
Copyright © 2022 Kilicel, De Crescenzo, Barbe, Edan, Curtis, Singh, Micali, Aubry, Mégevand, Eliez, Plessen and Armando.

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