Sustain and reinforce transition from child to adult mental health care in Switzerland: study protocol

Abstract

A suboptimal transition in mental health care affects a young person’s wellbeing and health in the long run. We aim to identify a large cohort of young people approaching the transition boundary between child and adolescent and adult mental health services in the canton of Geneva and implement the model of managed transition for a randomly selected subset. METHODS We will perform a nested-cohort randomised controlled trial, which is a modification of the multiple cohort randomised controlled trial, where the allocation to the intervention is conducted by cluster randomisation, with each distinct mental health service constituting a cluster. We will include 387 adolescents with a mental disorder, without intellectual disability and within 18 months of reaching the transition boundary. We will randomly allocate mental health services to the intervention (managed transition) or control group (treatment as usual). The primary outcome is the patient’s health status as measured by Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA) or Health of the Nation Outcome Scale for adults (HoNOS). CONCLUSIONS This is a protocol of a nested-cohort randomised controlled trial. This study will promote change in health systems management and administration. It will facilitate close collaboration between child and adolescent and adult mental health services, which for decades have been completely separated and differentiated.