Transition to adult mental health services for young people with attention deficit hyperactivity disorder in Italy: Parents’ and clinicians’ experiences

Abstract

Objective. The aim of this study was to describe the experiences of parents and clinicians in relation to the transition from child and adolescent neuropsychiatric services (CANPS) to adult services for people with attention deficit hyperactivity disorder (ADHD) in Italy. Methods. Parents of people with ADHD who reached the transition boundary for CANPS were sampled from the A.I.F.A. association (Italian Association of ADHD Families). We thematically analyzed informative and qualitative questionnaires completed by parents and clinicians. Results. Parents’ (n = 24) and clinicians’ (n = 27) experiences differed slightly on challenges and unmet needs, whereas clinicians agreed on the variables required for an optimal transition process. Poor transition and multiple barriers to such care were identified. Specifically, far fewer people received services, especially public health services, after reaching the age of 18, and perceived barriers included problems with user access, limited transition protocols, poor service coordination, and possible lack of ADHD-related knowledge on the part of adult practitioners. Conclusions. Care continuity in mental healthcare remains a need to be prioritized and better defined also for ADHD patients (and their parents). Parents’ and clinicians’ experiences are more likely to be positive if transition management is characterized by a gradual preparation, a period of parallel care, and commonly acknowledged, clear information on available services and how to access them. Identifying the needs and barriers of the people representing the different roles (clinicians, parents, and users) involved in the transition to adult mental health services is of particular importance in designing effective, shared transfer planning procedures.

Keywords:

• Attention deficit disorder
• health service use
• mental health services
• transition to adult care

Acknowledgements

This study is part of the “Sharing diagnostic-therapeutic approaches for ADHD in Lombardy” project partially funded by the Lombardy Region (D.G. sanità n. 3792 del 08/05/2014). Authors thank the families of the A.I.F.A. association. Grateful acknowledgement is made to Dr Chiara Pandolfini for manuscript language editing.

Ethical principles: This research was approved by the Institutional Review Board of the IRCCS - Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, Italy, and written informed consent was obtained for all patients.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.