The transition to adult mental health services from a secure inpatient environment: An Interpretative Phenomenological Analysis of the experiences of nursing staff

Within the UK, there are a growing number of young people diagnosed with mental health difficulties and therefore in receipt of Child and Adolescent Mental Health Services (CAMHS). Upon reaching age 18 years, institutional and legal requirements often necessitate a transition to Adult Mental Health Services (AMHS). Despite a national, top-down commitment to ensuring transitions are smooth, well-planned and person centred, often the reality is very different. Young people and professionals frequently report an experience marked by inconsistencies between CAMHS and AMHS, lack of collaboration, poor communication and high levels of uncertainty. The current literature review aimed to explore the experiences and perceptions of transition from CAMHS to AMHS, from the perspectives of professionals, young people and families. A meta-synthesis of eight studies revealed four sub-themes; facing identity dilemmas, needing containment and trusting relationships, changing responsibility and talking a different language. The themes were conceptualised as a line of argument demonstrating the complexity of the experience and the interplay between multiple factors. The findings offered an in depth insight into the experience of transition, reflecting previous research, that policy and recommended practice is not always experienced at the ground level. The current research study aimed to explore the experiences and insights of nursing staff on the transition to AMHS, within the context of a secure inpatient CAMH service. Semi-structured interviews were conducted with six experienced nursing staff within the adolescent service. Interpretative Phenomenological Analysis (IPA) generated four superordinate themes and 12 corresponding sub-themes. These themes were discussed in relation to existing theory and literature. Implications for clinical practice and future research were also discussed. The critical appraisal offers a reflective account of the research process. This aims to maximise transparency and offers a critique of the current research.