Barriers in Transition to Adult Mental Health Services: A Comprehensive Review
The transition from child to adult mental health services is a challenging process, especially for young people with autism spectrum disorder and attention deficit hyperactivity disorder (ADHD). This scoping review aims to explore the barriers and enablers in this transition, using a socioecological lens to understand the influences at different levels.
The Challenge of Transition
The review identified a significant gap in the literature, with most evidence focusing on institutional barriers rather than individual factors. Poor communication between child and adolescent mental health services and adult mental health services is a major issue, often leaving teams unsure about their roles in the transition process. This lack of clarity can lead to fragmented processes, inconsistent eligibility criteria, and uncertainty for neurodivergent young people and their families.
Enablers: Collaboration and Personalized Care
However, the study also highlighted the importance of collaboration and personalized care. When clinicians adapt their approaches to meet the sensory, cognitive, and communication needs of neurodivergent youth, engagement improves, and anxiety about the transition decreases. Involving young people in decision-making processes about their treatment plans empowers them and ensures that their preferences, priorities, and strengths are considered in adult service involvement.
Gaps in the Evidence
Despite these insights, there are still significant evidence gaps. The review found that few studies examined community-level factors, such as schools and peer networks, or policy-level influences like service funding and national guidance. Most data came from clinicians and caregivers, with only half of the included studies directly representing the voices of autistic and ADHD youth. This highlights the need for more comprehensive research that considers the perspectives of young people and addresses barriers at the service level, rather than solely focusing on individual-level solutions.
Policy Implications
This review emphasizes the importance of co-designing transition pathways with neurodivergent young people and addressing institutional barriers. By improving communication, collaboration, and personalized care, we can create a more seamless transition process that better supports the unique needs of these individuals.
Further Research and Discussion
The study invites further research to explore community-level factors and policy-level influences, ensuring that the transition process is informed by the perspectives of young people and their families. Additionally, it encourages discussion on how to best address institutional barriers and promote collaboration between child and adult mental health services.
Reference: Tang K et al. Barriers to and Enablers of the Transition From Child to Adult Mental Health Services for Autistic Young People and/or Those With Attention Deficit Hyperactivity Disorder: A Scoping Review. Child Care Health Dev. 2026;52(1):e70201.
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