Dr. Imelda Whyte:

It is not a straightforward answer. Transitions are always difficult. They are difficult, to various degrees, for everybody. As my colleague has indicated, Iocally I know from my own experience some services will say a patient is going to be doing his or her leaving certificate in June so we are going to keep her or her on and then once he or she transitions, so there is flexibility. I suppose it is our own responsibility to engage with the adult services and CAMHS and figure out what is in the best interest, believe it or not, of the patient, what will work for him or her and what will make it easier.

Introducing another mid-way service for those aged between 16 and 25 years has merit but also brings its own issues. Are you going to have two lots of transitions, that is, are you going to transition aged 18 years and then again aged 25 years? It will depend on your presentation and the cohort. There are implications for how health services are set up at the moment and how that gets broken down. What impact does that have on CAMHS? What age does it start at? What age does it end at, and all of that. Again, as somebody has already referenced, CAMHS previously worked up to 16 years and in more recent years has been extended up to 18 years. From an inpatient unit perspective that works quite well. CAMHS inpatient units have people aged up to 18 years. One cannot have an adult in a child unit. Are inpatient services going to reflect that new proposed form? As I said, there is no simple answer to it.

As part of the Sharing the Vision working group there are many different people looking at that and many different views but whatever will be patient-centred is what you would hope would come out. There is the training aspect. Are the people who work in those services going to be trained in child and in adult services? Where do those jobs exist? What do they look like? I am raising more issues than I am giving answers but what I am saying is-----