Transition of care from child to adult mental health services: the great divide
Child; Humans; Young Adult; Great Britain; Adult; Health Policy; Health Services Needs and Demand; Health Services Research; Outcome and Process Assessment (Health Care); adolescent; Adolescent Transitions; Continuity of Patient Care/organization & administration; Adolescent Health Services/organization & administration; Child Health Services/organization & administration; Community Mental Health Services/organization & administration; Mental Disorders/diagnosis/psychology/therapy
PURPOSE OF REVIEW: Adolescents with mental health problems often require transition of care from child and adolescent to adult mental health services. This review is a synthesis of current research and policy literature on transition to describe the barriers at the interface between child and adolescent mental health services and adult mental health services and outcomes of poor transition. RECENT FINDINGS: Adolescence is a risk period for emergence of serious mental disorders. Child and adolescent mental health services and adult mental health services use rigid age cut-offs to delineate service boundaries, creating discontinuities in provision of care. Adolescent mental health services are patchy across the world. Several recent studies have confirmed that problems occur during transition in diverse settings across several countries. In physical health, there are emerging models of practice to improve the process and outcomes of transition, but there is very little comparable literature in mental healthcare. SUMMARY: Poor transition leads to disruption in continuity of care, disengagement from services and is likely to lead to poorer clinical outcomes. Some young people, such as those with neurodevelopmental disorders and complex needs, are at a greater risk of falling through the care gap during transition. Services need robust and high-quality evidence on the process and outcomes of transition so that effective intervention strategies can be developed.
2009
Singh SP
Current Opinion In Psychiatry
2009
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1097/YCO.0b013e32832c9221" target="_blank" rel="noreferrer">10.1097/YCO.0b013e32832c9221</a>
Understanding sleep-wake behavior and sleep disorders in children: the value of a model
Child; Humans; Age Factors; Sleep Disorders; Time Factors; Crying; Predictive Value of Tests; adolescent; Preschool; infant; Models; Homeostasis; Behavior/physiology; Sleep Disorders/physiopathology; Biological; Adolescent Behavior/physiology; Child Behavior/physiology; Circadian Rhythm/physiopathology; Comprehension/physiology; Infant Behavior/physiology; Sleep/physiology; Wakefulness/physiology
PURPOSE OF REVIEW: Sleep-wake problems such as night wakings, excessive crying, or difficulties in falling asleep are frequent behavioral issues during childhood. Maturational changes in sleep and circadian regulation likely contribute to the development and maintenance of such problems. This review highlights the recent research examining bioregulatory sleep mechanisms during development and provides a model for predicting sleep-wake behavior in young humans. RECENT FINDINGS: Findings demonstrate that circadian and sleep homeostatic processes exhibit maturational changes during the first two decades of life. The developing interaction of both processes may be a key determinant of sleep-wake and crying behavior in infancy. Evidence shows that the dynamics of sleep homeostatic processes slow down in the course of childhood (i.e., sleep pressure accumulates more slowly with increasing age) enabling children to be awake for consolidated periods during the day. Another current topic is the adolescent sleep phase delay, which appears to be driven primarily by maturational changes in sleep homeostatic and circadian processes. SUMMARY: The two-process model of sleep regulation is a valuable framework for understanding and predicting sleep-wake behavior in young humans. Such knowledge is important for improving anticipatory guidance, parental education, and patient care, as well as for developing appropriate social policies.
2006
Jenni OG; LeBourgeois MK
Current Opinion In Psychiatry
2006
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1097/01.yco.0000218599.32969.03" target="_blank" rel="noreferrer">10.1097/01.yco.0000218599.32969.03</a>