Mind the Gap: Parental Perspectives on Mental Health Service Transitions for Young Adults with Anorexia Nervosa

Introduction:
The transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health
Services (AMHS) is known to be difficult. For young persons (YP) with anorexia nervosa (AN)
transitioning between services might be particularly challenging due to the timing, often coinciding with
other key life changes. The potential consequences of inadequate transition are many: treatment
dropout, heightened symptom load, and increased distress amongst patients and relatives. Furthermore,
the parent-child relationship may be affected by the changes related to service transition. Parents are
highly involved in treatment in CAMHS, but have a less central role in AMHS, therefore, their experience
of transition is important to fully grasp potential problems or shortcomings of the transition processes
and thereby improve it. The parental voice has not received much attention to date. This study aimed to
describe common themes in parental experiences of their role, when their YP transitions from CAMHS to
AMHS.
Methods
A total of seven parents were included, three fathers, three mothers and one stepmother. Parents were
interviewed using a semi-structured interview guide focused on their experiences of the transition
process. The data was analyzed using empirically testing thematic analysis.
Results
The analysis revealed 3 superordinate themes relating to the parental experience of transition: 1) The
transition process, 2) Autonomy and independence, and 3) Shift in parental role. The parents´ overall
experience of the transition process was that it was unsatisfactory, and in their view a cause of
increased anxiety and a worsening of symptoms in the YP. Furthermore, parents described feeling
anxious and uncertain regarding the new personal and legal autonomy and independence that the YP
had in the AMHS. Finally, the large shift in parental role was challenging, although, for some it improved
the parent-child relationship.
Discussion
parents can be highly affected by the transition process and the shift in involvement, and the parent-child
relationship can both improve or strain in this phase. Furthermore, several parents experienced their
child having adverse outcomes of the transition process or lack thereof. Future research can benefit
from including parental perspectives on transitioning in healthcare for YP with AN.