Managing the link and strengthening transition from child to adult mental health Care in Europe (MILESTONE): background, rationale and methodology

H Tuomainen, U Schulze, J Warwick, M Paul, G C Dieleman, T Franić, J Madan, A Maras, F McNicholas, D Purper-Ouakil, P Santosh, G Signorini, C Street, S Tremmery, F C Verhulst, D Wolke, S P Singh, MILESTONE consortium, Swaran Singh, Helena Tuomainen, Jason Madan, Moli Paul, Cathy Street, Dieter Wolke, Jane Warwick, Priya Tah, Alastair Canaway, James Griffin, Philip Wells, Rebecca Appleton, Rose-Marie Lomax, Amanda Tuffrey, Anna Wilson, Charlotte Gatherer, Leanne Walker, Giovanni de Girolamo, Giulia Signorini, Giovanni Allibrio, Marco Armando, Stefano Vicari, Angelo Bertani, Giuseppe Carrà, Patrizia Conti, Francesco Margari, Ottaviano Martinelli, Emiliano Monzani, Francesco Rinaldi, Paolo Stagi, Paolo Scocco, Fabio Vanni, Alessandro Ferrari, Elisa Gheza, Cecilia Ferrari, Laura Rivolta, Flavia Levi, Maria Cataldo, Lidia Manenti, Giorgia Morini, Adriana Pastore, Cecilia Toselli, Pamela Varvara, Paramala Santosh, Natalie Heaney, Ilyas Sagar-Ouriaghli, Mathilde Mastroianni, Jatinder Singh, Diane Purper-Ouakil, Frédérick Russet, Virginie Maurice, Véronique Humbertclaude, Athanasios Maras, Larissa van Bodegom, Mathilde Overbeek, Arthur Van Gool, Therese van Amersfoort, Ulrike Schulze, Jörg M Fegert, Paul Plener, Melanie Saam, Ulrike Breuninger, Anne Sartor, Elena Tanase, Renate Schepker, Michele Noterdaeme, Sabine Tremmery, Gaëlle Hendrickx, Fiona McNicholas, Aleksandra Gronostaj, Ingrid Holme, Lesley O'Hara, Ana Paula Paes de Mello de Camargo, Tomislav Franić, Nikolina Davidović, Paramala Santosh, Kate Lievesley, Federico Fiori, Frank Verhulst, Gwen Dieleman, Suzanne Gerritsen, Andrea Wohner, Sarah Buttle, Meghan Killilea, Courtney Smyth, Caoimhe Kelly, James Kirwin, H Tuomainen, U Schulze, J Warwick, M Paul, G C Dieleman, T Franić, J Madan, A Maras, F McNicholas, D Purper-Ouakil, P Santosh, G Signorini, C Street, S Tremmery, F C Verhulst, D Wolke, S P Singh, MILESTONE consortium, Swaran Singh, Helena Tuomainen, Jason Madan, Moli Paul, Cathy Street, Dieter Wolke, Jane Warwick, Priya Tah, Alastair Canaway, James Griffin, Philip Wells, Rebecca Appleton, Rose-Marie Lomax, Amanda Tuffrey, Anna Wilson, Charlotte Gatherer, Leanne Walker, Giovanni de Girolamo, Giulia Signorini, Giovanni Allibrio, Marco Armando, Stefano Vicari, Angelo Bertani, Giuseppe Carrà, Patrizia Conti, Francesco Margari, Ottaviano Martinelli, Emiliano Monzani, Francesco Rinaldi, Paolo Stagi, Paolo Scocco, Fabio Vanni, Alessandro Ferrari, Elisa Gheza, Cecilia Ferrari, Laura Rivolta, Flavia Levi, Maria Cataldo, Lidia Manenti, Giorgia Morini, Adriana Pastore, Cecilia Toselli, Pamela Varvara, Paramala Santosh, Natalie Heaney, Ilyas Sagar-Ouriaghli, Mathilde Mastroianni, Jatinder Singh, Diane Purper-Ouakil, Frédérick Russet, Virginie Maurice, Véronique Humbertclaude, Athanasios Maras, Larissa van Bodegom, Mathilde Overbeek, Arthur Van Gool, Therese van Amersfoort, Ulrike Schulze, Jörg M Fegert, Paul Plener, Melanie Saam, Ulrike Breuninger, Anne Sartor, Elena Tanase, Renate Schepker, Michele Noterdaeme, Sabine Tremmery, Gaëlle Hendrickx, Fiona McNicholas, Aleksandra Gronostaj, Ingrid Holme, Lesley O'Hara, Ana Paula Paes de Mello de Camargo, Tomislav Franić, Nikolina Davidović, Paramala Santosh, Kate Lievesley, Federico Fiori, Frank Verhulst, Gwen Dieleman, Suzanne Gerritsen, Andrea Wohner, Sarah Buttle, Meghan Killilea, Courtney Smyth, Caoimhe Kelly, James Kirwin

Abstract

Background: Transition from distinct Child and Adolescent Mental Health (CAMHS) to Adult Mental Health Services (AMHS) is beset with multitude of problems affecting continuity of care for young people with mental health needs. Transition-related discontinuity of care is a major health, socioeconomic and societal challenge globally. The overall aim of the Managing the Link and Strengthening Transition from Child to Adult Mental Health Care in Europe (MILESTONE) project (2014-19) is to improve transition from CAMHS to AMHS in diverse healthcare settings across Europe. MILESTONE focuses on current service provision in Europe, new transition-related measures, long term outcomes of young people leaving CAMHS, improving transitional care through 'managed transition', ethics of transitioning and the training of health care professionals.

Methods: Data will be collected via systematic literature reviews, pan-European surveys, and focus groups with service providers, users and carers, and members of youth advocacy and mental health advocacy groups. A prospective cohort study will be conducted with a nested cluster randomised controlled trial in eight European Union (EU) countries (Belgium, Croatia, France, Germany, Ireland, Italy, Netherlands, UK) involving over 1000 CAMHS users, their carers, and clinicians.

Discussion: Improving transitional care can facilitate not only recovery but also mental health promotion and mental illness prevention for young people. MILESTONE will provide evidence of the organisational structures and processes influencing transition at the service interface across differing healthcare models in Europe and longitudinal outcomes for young people leaving CAMHS, solutions for improving transitional care in a cost-effective manner, training modules for clinicians, and commissioning and policy guidelines for service providers and policy makers.

Trial registration: "MILESTONE study" registration: ISRCTN ISRCTN83240263 Registered 23 July 2015; ClinicalTrials.gov NCT03013595 Registered 6 January 2017.

Keywords: Child and adolescent mental health services; Cluster randomised controlled trial; Europe; Health services research; Longitudinal cohort study; Mental health; Policy; Professional training; Transition; Youth mental health.

Conflict of interest statement

Ethics approval and consent to participate

The MILESTONE study protocol (covering studies in WP 3, 4, 5 and 6 focus groups) received favourable ethical opintion from West Midlands - South Birmingham Research Ethics Committee (ref. 15/WM/0052). The Protocol for development and e-monitoring using the MILESTONE Suite of Measures (covering study 2) was approved by the the NRES Committee London - Camberwell St Giles (ref. 14/LO/1049). In both instances, approvals were gained from equivalent ethics boards in participating countries. For WP 6 first round of focus groups, Saint John of God Hospitaller Services in the Republic of Ireland granted a favourable opinion (ref. 604/583) and these were also obtained from equivalent bodies in the UK and Croatia.

Competing interests

Frank C. Verhulst is a contributing author of the Achenbach System of Empirically Based Assessments, for which he receives remuneration. Paramala Santosh is the director of HealthTacker Ltd.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Research projects within MILESTONE. Green hexagons: research involving the eight MILESTONE countries only. Grey hexagons: research involving all European countries

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Source: PubMed

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