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      Prioritizing core components of successful transitions from child to adult mental health care : a national Delphi survey with youth, caregivers, and health professionals

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          Abstract

          Youth accessing mental health care often experience a disruption in care as they attempt to transition between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS). Few studies have evaluated interventions seeking to improve the experience and outcomes of CAMHS–AMHS transitions, in part due to lack of consensus on what constitutes best practices in intervention success. As such, the aim of this study was to engage patients, caregivers, and clinicians to prioritize core components of successful CAMHS–AMHS transitions which can be used in the design or evaluation of transition interventions. As such, a Delphi study was conducted to determine core components of successful CAMHS–AMHS transitions. Guided by the principles of patient-oriented research, three balanced expert panels consisting of youth, caregivers, and clinicians ranked and provided feedback on the importance and feasibility of core components of CAMHS-AMHS transitions. Components endorsed as feasible or important with ≥ 70% agreement from any panel moved to the next round. As a result, a list of 26 core components of CAMHS–AMHS transitions has been refined which can be used in the design, implementation, or evaluation of interventions intended to improve transition experiences and outcomes for youth in mental health care. Youth and families were engaged in an expert advisory role throughout the research process, contributing their important perspectives to the design and implementation of this study, as well as interpretation of the findings.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s00787-021-01806-6.

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          Using thematic analysis in psychology

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            Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support.

            Research electronic data capture (REDCap) is a novel workflow methodology and software solution designed for rapid development and deployment of electronic data capture tools to support clinical and translational research. We present: (1) a brief description of the REDCap metadata-driven software toolset; (2) detail concerning the capture and use of study-related metadata from scientific research teams; (3) measures of impact for REDCap; (4) details concerning a consortium network of domestic and international institutions collaborating on the project; and (5) strengths and limitations of the REDCap system. REDCap is currently supporting 286 translational research projects in a growing collaborative network including 27 active partner institutions.
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              Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication.

              Little is known about the general population prevalence or severity of DSM-IV mental disorders. To estimate 12-month prevalence, severity, and comorbidity of DSM-IV anxiety, mood, impulse control, and substance disorders in the recently completed US National Comorbidity Survey Replication. Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using a fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview. Nine thousand two hundred eighty-two English-speaking respondents 18 years and older. Twelve-month DSM-IV disorders. Twelve-month prevalence estimates were anxiety, 18.1%; mood, 9.5%; impulse control, 8.9%; substance, 3.8%; and any disorder, 26.2%. Of 12-month cases, 22.3% were classified as serious; 37.3%, moderate; and 40.4%, mild. Fifty-five percent carried only a single diagnosis; 22%, 2 diagnoses; and 23%, 3 or more diagnoses. Latent class analysis detected 7 multivariate disorder classes, including 3 highly comorbid classes representing 7% of the population. Although mental disorders are widespread, serious cases are concentrated among a relatively small proportion of cases with high comorbidity.
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                Author and article information

                Contributors
                k.cleverley@utoronto.ca
                Journal
                Eur Child Adolesc Psychiatry
                Eur Child Adolesc Psychiatry
                European Child & Adolescent Psychiatry
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1018-8827
                1435-165X
                5 June 2021
                5 June 2021
                2022
                : 31
                : 11
                : 1739-1752
                Affiliations
                [1 ]GRID grid.17063.33, ISNI 0000 0001 2157 2938, Lawrence S. Bloomberg Faculty of Nursing, , University of Toronto, ; 155 College Street, Suite 130, Toronto, ON M5T 1P8 Canada
                [2 ]Yorktown Family Services, Toronto, Canada
                [3 ]GRID grid.25073.33, ISNI 0000 0004 1936 8227, Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, , McMaster University, ; Hamilton, Canada
                [4 ]GRID grid.491040.8, Sashbear Foundation, ; Toronto, Canada
                [5 ]GRID grid.155956.b, ISNI 0000 0000 8793 5925, Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health and Campbell Family Mental Health Research Institute, , Centre for Addiction and Mental Health, ; Toronto, Canada
                [6 ]GRID grid.17063.33, ISNI 0000 0001 2157 2938, Department of Psychiatry, Faculty of Medicine, , University of Toronto, ; Toronto, Canada
                [7 ]GRID grid.250674.2, ISNI 0000 0004 0626 6184, Lunenfeld-Tanenbaum Research Institute, Sinai Health, System, ; Toronto, Canada
                [8 ]GRID grid.17063.33, ISNI 0000 0001 2157 2938, Institute of Health Policy, Management and Evaluation, , University of Toronto, ; Toronto, Canada
                [9 ]GRID grid.415502.7, Li Ka Shing Knowledge Institute, St Michael’s Hospital, ; Toronto, Canada
                [10 ]GRID grid.17063.33, ISNI 0000 0001 2157 2938, Factor-Inwentash Faculty of Social Work, , University of Toronto, ; Toronto, Canada
                [11 ]GRID grid.42327.30, ISNI 0000 0004 0473 9646, Department of Psychiatry, , The Hospital for Sick Children, ; Toronto, Canada
                [12 ]GRID grid.42327.30, ISNI 0000 0004 0473 9646, Centre for Brain and Mental Health and Department of Psychiatry, , The Hospital for Sick Children, ; Toronto, Canada
                [13 ]GRID grid.155956.b, ISNI 0000 0000 8793 5925, The Cundill Centre for Child and Youth Depression, , Centre for Addiction and Mental Health, ; Toronto, Canada
                Author information
                http://orcid.org/0000-0002-2822-2129
                http://orcid.org/0000-0002-9387-5193
                Article
                1806
                10.1007/s00787-021-01806-6
                9666300
                34089382
                0f00806e-a1ff-4393-9499-c38b1a95151c
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 14 January 2021
                : 15 May 2021
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000024, Canadian Institutes of Health Research;
                Award ID: FRN 151744
                Award Recipient :
                Categories
                Original Contribution
                Custom metadata
                © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany 2022

                Clinical Psychology & Psychiatry
                transition,continuity of care,mental health,youth,delphi study,consensus,patient-oriented research

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