Learn about moving from mental health services for youth into the adult services system, and what resources are available in Ontario to help with that change.
Making the transition from youth to adult
When someone engaged in mental health services for youth reaches the age of 18 or thereabouts, it is time for them to transition into the adult mental health system. This can be a difficult time for a young person and their family. Fortunately, support for the young person does not have to stop. With planning, care can continue for the young person, in a system providing ongoing support.
Preparation and timing
Around age 18, a person obtains adult status in many programs and systems, including the mental health system, and therefore must receive support within the adult system. However, it is important to start planning a transition before the youth involved turns 18. Start to speak to your support team about transition when the youth is 16, or even earlier for youth with very serious chronic conditions.
Not only does transition between the youth and adult mental health system involve changes in setting, it is also a transition to independence. Transitioning may include:
- A new facility or department
- New staff
- A new treatment plan
The adult mental health system can be very different from the youth system. Families, caregivers and youth can expect that they will be cared for and supported in a different way. One important difference is the amount of responsibility and independence the young person will now have. It is an opportunity for them to gain life skills that foster independence in new, untried ways. Speaking to the care team about these changes can help to prepare the family as well as the youth, and ease the transition process.
Common challenges for emerging adults
The transition between systems is based on physical, chronological age, not developmental age. This means that a young person may reach the age of transition, but still rely on the level of support that is typical for someone in the child and youth mental health system.
During the time of transition, young people are being put in the “driver’s seat” — they are the driver of their own care. Some skills, such as going to appointments alone or picking up prescriptions themselves, may still be developing at the age of transition. This means that this period of care can be intimidating for the young person. With the right supports, transitioning can be viewed as an exciting time of increased independence and the development of new skills.
Transitioning youth may find themselves involved with several components:
- The child and youth mental health system
- The adult mental health system
- Specific transition-aged youth programs (a mix of the above systems) that support this specific age group
Some young people who have not previously been connected to the child and youth mental health system may need access to adult services. It is also possible that transition-aged youth programs are not locally available. The sectors involved in the young person’s care will differ on a case-by-case basis.
Supporting a successful transition
The most successful transitions include:
- The young person at the centre, driving the care
- A plan that starts early
- Involvement of family and caregivers
- Collaboration and communication between the youth and adult mental health systems
- A coordinated approach among all service providers
- Skills training for the young person
One way to empower youth is to work with them to develop a Health Passport to bring awareness to details of their own health. MyHealthPassport is an online tool from the Hospital for Sick Children that allows youth to carry their personal health information with them, which can make them feel more prepared to discuss their health with new health care providers. This tool is available at http://www.sickkids.ca/Good2Go/For-Youth-and-Families/Transition-Tools/MyHealth-Passport/Index.html
Preparing for a transition
The best transitions happen when the youth, family, and care providers all feel prepared. The first step in beginning this transition is a discussion among youth, families and health care providers in the youth system about the need for a referral to the adult mental health system. Sometimes, the health care provider will begin this discussion; other times, the young person and their family may need to advocate for early preparation. Discussing the youth’s needs can help ensure that the adult service will be the right fit.
Once the referral has been made, and an adult care provider is chosen, the young person can enter a period of parallel care, when the youth is connected with both the youth and the adult mental health systems. This can make the transition much more comfortable. The youth may also be participating in a transition-aged youth program at this time.
During the period of parallel care:
- The family and youth can build a relationship with the new adult care staff
- The family and youth can begin to say goodbye to their youth care staff
- The family and youth can learn about the changes they can expect
- Information can be shared between the youth and adult mental health system
During this time, a transitioning toolkit can be helpful. A transitioning toolkit is a set of worksheets that can help a young person communicate with the transition team.
Resources for families and caregivers transitioning from youth to adult mental health services include the following:
Office of the Provincial Advocate for Children and Youth
The Advocate’s Office is an independent voice for Ontario’s children and youth who are either “in care” or on the margins of government care.
Parents Lifeline of Eastern Ontario
PLEO provides support and information for parents and caregivers with young people facing mental health challenges, including how to advocate for, and navigate a transition.
Good2Go: Tips for Parents and Caregivers
Getting Ready for Adult Care
A guide created by the Hospital for Sick Children to help families prepare for the transition.
Surrey Place Centre
Transition Toolkit: Health Care Transition Tools and Resources for Families and Caregivers of Youth with Developmental Disabilities