Managing the link and strengthening transition from child to adult mental health Care in Europe (MILESTONE): background, rationale and methodology

H Tuomainen; U Schulze; J Warwick; M Paul; G C Dieleman; T Franić; J Madan; A Maras; F McNicholas; D Purper-Ouakil; P Santosh; G Signorini; C Street; S Tremmery; F C Verhulst; D Wolke; S P Singh; MILESTONE consortium

doi:10.1186/s12888-018-1758-z

Managing the link and strengthening transition from child to adult mental health Care in Europe (MILESTONE): background, rationale and methodology

BMC Psychiatry. 2018 Jun 4;18(1):167. doi: 10.1186/s12888-018-1758-z.

Authors

H Tuomainen¹, U Schulze², J Warwick³, M Paul^{4

5}, G C Dieleman⁶, T Franić⁷, J Madan⁸, A Maras^{6

9}, F McNicholas^{10

11

12

13}, D Purper-Ouakil¹⁴, P Santosh^{15

16

17}, G Signorini¹⁸, C Street⁴, S Tremmery^{19

20}, F C Verhulst⁶, D Wolke^{4

21}, S P Singh⁴; MILESTONE consortium

Collaborators

MILESTONE consortium:
Swaran Singh, Helena Tuomainen, Jason Madan, Moli Paul, Cathy Street, Dieter Wolke, Jane Warwick, Priya Tah, Alastair Canaway, James Griffin, Philip Wells, Rebecca Appleton, Rose-Marie Lomax, Amanda Tuffrey, Anna Wilson, Charlotte Gatherer, Leanne Walker, Giovanni de Girolamo, Giulia Signorini, Giovanni Allibrio, Marco Armando, Stefano Vicari, Angelo Bertani, Giuseppe Carrà, Patrizia Conti, Francesco Margari, Ottaviano Martinelli, Emiliano Monzani, Francesco Rinaldi, Paolo Stagi, Paolo Scocco, Fabio Vanni, Alessandro Ferrari, Elisa Gheza, Cecilia Ferrari, Laura Rivolta, Flavia Levi, Maria Cataldo, Lidia Manenti, Giorgia Morini, Adriana Pastore, Cecilia Toselli, Pamela Varvara, Paramala Santosh, Natalie Heaney, Ilyas Sagar-Ouriaghli, Mathilde Mastroianni, Jatinder Singh, Diane Purper-Ouakil, Frédérick Russet, Virginie Maurice, Véronique Humbertclaude, Athanasios Maras, Larissa van Bodegom, Mathilde Overbeek, Arthur Van Gool, Therese van Amersfoort, Ulrike Schulze, Jörg M Fegert, Paul Plener, Melanie Saam, Ulrike Breuninger, Anne Sartor, Elena Tanase, Renate Schepker, Michele Noterdaeme, Sabine Tremmery, Gaëlle Hendrickx, Fiona McNicholas, Aleksandra Gronostaj, Ingrid Holme, Lesley O'Hara, Ana Paula Paes de Mello de Camargo, Tomislav Franić, Nikolina Davidović, Paramala Santosh, Kate Lievesley, Federico Fiori, Frank Verhulst, Gwen Dieleman, Suzanne Gerritsen, Andrea Wohner, Sarah Buttle, Meghan Killilea, Courtney Smyth, Caoimhe Kelly, James Kirwin

Affiliations

¹ Mental Health and Wellbeing, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK. helena.tuomainen@warwick.ac.uk.
² Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.
³ Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
⁴ Mental Health and Wellbeing, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
⁵ Coventry and Warwickshire Partnership NHS Trust, Coventry, UK.
⁶ Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, Netherlands.
⁷ Department of Psychiatry, Clinical Hospital Center Split, Split, Croatia.
⁸ Warwick Medical School, University of Warwick, Coventry, UK.
⁹ Yulius Academy, Yulius Mental Health Organization, Barendrecht, Netherlands.
¹⁰ Department of Child and Adolescent Psychiatry, University College Dublin School of Medicine and Medical Science, Dublin, Republic of Ireland.
¹¹ Geary Institute, University College Dublin, Dublin, Republic of Ireland.
¹² Department of Child Psychiatry, Our Lady's Hospital for Sick Children, Dublin, Republic of Ireland.
¹³ Lucena Clinic SJOG, Dublin, Republic of Ireland.
¹⁴ Centre Hospitalier Universitaire de Montpellier, Montpellier, France.
¹⁵ Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
¹⁶ HealthTracker Ltd, Gillingham, UK.
¹⁷ Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), National and Specialist Child and Adolescent Mental Health Services, Maudsley Hospital, London, UK.
¹⁸ Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy.
¹⁹ Department of Neurosciences, Child & Adolescent Psychiatry, University of Leuven, Leuven, Belgium.
²⁰ Department of Child & Adolescent Psychiatry, University Hospitals Leuven, Leuven, Belgium.
²¹ Department of Psychology, University of Warwick, Coventry, UK.

Abstract

Background: Transition from distinct Child and Adolescent Mental Health (CAMHS) to Adult Mental Health Services (AMHS) is beset with multitude of problems affecting continuity of care for young people with mental health needs. Transition-related discontinuity of care is a major health, socioeconomic and societal challenge globally. The overall aim of the Managing the Link and Strengthening Transition from Child to Adult Mental Health Care in Europe (MILESTONE) project (2014-19) is to improve transition from CAMHS to AMHS in diverse healthcare settings across Europe. MILESTONE focuses on current service provision in Europe, new transition-related measures, long term outcomes of young people leaving CAMHS, improving transitional care through 'managed transition', ethics of transitioning and the training of health care professionals.

Methods: Data will be collected via systematic literature reviews, pan-European surveys, and focus groups with service providers, users and carers, and members of youth advocacy and mental health advocacy groups. A prospective cohort study will be conducted with a nested cluster randomised controlled trial in eight European Union (EU) countries (Belgium, Croatia, France, Germany, Ireland, Italy, Netherlands, UK) involving over 1000 CAMHS users, their carers, and clinicians.

Discussion: Improving transitional care can facilitate not only recovery but also mental health promotion and mental illness prevention for young people. MILESTONE will provide evidence of the organisational structures and processes influencing transition at the service interface across differing healthcare models in Europe and longitudinal outcomes for young people leaving CAMHS, solutions for improving transitional care in a cost-effective manner, training modules for clinicians, and commissioning and policy guidelines for service providers and policy makers.

Trial registration: "MILESTONE study" registration: ISRCTN ISRCTN83240263 Registered 23 July 2015; ClinicalTrials.gov NCT03013595 Registered 6 January 2017.

Keywords: Child and adolescent mental health services; Cluster randomised controlled trial; Europe; Health services research; Longitudinal cohort study; Mental health; Policy; Professional training; Transition; Youth mental health.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adolescent Health Services* / economics
Adolescent Health Services* / trends
Adult
Child
Cohort Studies
Cost-Benefit Analysis / methods
Cost-Benefit Analysis / trends
Europe / epidemiology
Female
Health Personnel / economics
Health Personnel / trends
Humans
Male
Mental Health Services* / economics
Mental Health Services* / trends
Mental Health* / economics
Mental Health* / trends
Multicenter Studies as Topic / economics
Multicenter Studies as Topic / methods
Patient Transfer / economics
Patient Transfer / methods*
Patient Transfer / trends
Prospective Studies
Randomized Controlled Trials as Topic / economics
Randomized Controlled Trials as Topic / methods
Surveys and Questionnaires
Systematic Reviews as Topic

Associated data

ClinicalTrials.gov/NCT03013595
ISRCTN/ISRCTN83240263