Nervenheilkunde 2022; 41(09): 560-568
DOI: 10.1055/a-1824-7839
Schwerpunkt

Unterstützungsmöglichkeiten von jungen Erwachsenen mit einer psychischen Erkrankung und Herausforderungen während der Transition

Support opportunities for young adults with a mental illness and challenges of the transition phase
Ayca Ilgaz
1   Abteilung für Klinische Psychologie und Psychotherapie, Institut für Psychologie und Pädagogik, Universität Ulm
,
Jörg M. Fegert
2   Abteilung Kinder- und Jugendpsychiatrie, Psychotherapie am Universitätsklinikum Ulm
,
Ulrike M. E. Schulze
2   Abteilung Kinder- und Jugendpsychiatrie, Psychotherapie am Universitätsklinikum Ulm
3   ZfP Calw, Klinikum Nordschwarzwald, Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie Böblingen
,
Harald Baumeister
1   Abteilung für Klinische Psychologie und Psychotherapie, Institut für Psychologie und Pädagogik, Universität Ulm
› Author Affiliations

ZUSAMMENFASSUNG

Der Übergang von der kinder- und jugendpsychiatrischen und -psychotherapeutischen Versorgung (KJPP) zu Versorgungsangeboten im Erwachsenenbereich stellt für junge Menschen mit psychischen Erkrankungen eine Herausforderung dar. Es drohen Behandlungsabbrüche, die Behandlungs- und Versorgungskontinuität ist gefährdet. Erfahrungen zeigen, dass nur ein kleiner Teil der jungen Erwachsenen einen reibungslosen Übergang erlebt, während die Mehrheit in die „Transitionslücke“ fällt. Nach einer Übersichtsdarstellung zu Forschungsergebnissen zu hiermit verbundenen Hindernissen innerhalb des Gesundheits- und Sozialsystems, stellt dieser Artikel traditionelle und neue digitale Möglichkeiten (ProTransition-App) zur Unterstützung junger Menschen in dieser Lebensphase vor.

ABSTRACT

The transition from child and adolescent mental health care services (CAMHS) to adult mental health care services (AMHS) poses a challenge for young adults with mental disorders. This phase is associated with a lack of opportunities to support young adults after aging out from the CAMHS which put the continuity of their treatment at risk. Experience shows that only a small proportion of young adults undergo a smooth transition, while the majority fall into the alleged “transition gap”. The following article provides a review of previous research on the transition gap both in the health and social care systems and presents traditional as well as digital opportunities (the ProTransition-App) to support young adults during this critical phase.



Publication History

Article published online:
02 September 2022

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  • Literatur

  • 1 Arnett JJ. Emerging adulthood: A theory of development from the late teens through the twenties. Am Psychol 2000; 55: 469-480
  • 2 Wood D, Crapnell T, Lau L. et al Emerging Adulthood as a Critical Stage in the Life Course. In: Halfon N et al. (eds) Handbook of Life Course Health Development. Berlin: Springer; 2018: 123-143
  • 3 Fegert JM, Hauth I, Banaschewski T. et al Übergang zwischen Jugend- und Erwachsenenalter. Psychotherapeut 2017; 62: 34-38
  • 4 Signorini G, Singh SP, Marsanic VB. et al The interface between child/adolescent and adult mental health services: results from a European 28-country survey. Eur Child Adolesc Psychiatry 2018; 27: 501-511
  • 5 Toulany A, Stukel TA, Kurdyak P. et al Association of primary care continuity with outcomes following transition to adult care for adolescents with severe mental illness. JAMA Netw Open. 2019 DOI: 10.1001/jamanetworkopen.2019.8415
  • 6 Appleton R, Connell C, Fairclough E. et al Outcomes of young people who reach the transition boundary of child and adolescent mental health services: a systematic review. Eur Child Adolesc Psychiatry 2019; 28: 1431-1446
  • 7 Hill A, Wilde S, Tickle A. Review: Transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS): a meta-synthesis of parental and professional perspectives. Child Adolesc Mental Health 2019; 24: 295-306
  • 8 Lindgren E, Söderberg S, Skär L. The Gap in Transition Between Child and Adolescent Psychiatry and General Adult Psychiatry. J Child Adolesc Psychiatr Nurs 2013; 26: 103-109
  • 9 Loos S, Walia N, Becker T. et al Lost in transition? Perceptions of health care among young people with mental health problems in Germany: a qualitative study. Child Adolesc Psychiatr Ment Health 2018; 12: 41
  • 10 Loos S, Walia N, Becker T. et al Lost in transition? Professional perspectives on transitional mental health services for young people in Germany: a qualitative study. BMC Health Serv Res 2018; 18: 649
  • 11 Paul M, Ford T, Kramer T. et al Transfers and transitions between child and adult mental health services. Br J Psychiatry Suppl 2013; 54: 36-40
  • 12 McNicholas F, Adamson M, McNamara N. et al Who is in the transition gap? Transition from CAMHS to AMHS in the Republic of Ireland. Ir J Psychol Med 2015; 32: 61-69
  • 13 Aujoulat I, Mustin L, Martin F. et al The Application of Salutogenesis to Health Development in Youth with Chronic Conditions. In: Mittelmark MB. et al, (eds.). The Handbook of Salutogenesis. Berlin: Springer; 2016: 337-344
  • 14 Radez J, Reardon T, Creswell C. et al Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies. Eur Child Adolesc Psychiatry 2021; 30: 183-211
  • 15 Plener PL, Rebecca C, Groschwitz RC. et al Die stationäre psychiatrische Versorgung Adoleszenter in Deutschland. Zeitschrift für Psychiatr Psychol und Psychother 2015; 63: 181-186
  • 16 Collins A, Muñoz-Solomando A. The transition from child and adolescent to adult mental health services with a focus on diagnosis progression. BJ Psych Bull 2018; 42: 188-192
  • 17 Yap MBH, Reavley N, Jorm AF. Where would young people seek help for mental disorders and what stops them? Findings from an Australian national survey. J Affect Disord 2013; 147: 255-61 DOI: 10.1016/j.jad.2012.11.014.
  • 18 McLaren S, Belling R, Paul M. et al ‘Talking a different language’: an exploration of the influence of organizational cultures and working practices on transition from child to adult mental health services. BMC Health Serv Res 2013; 13: 254
  • 19 Dunn V. Young people, mental health practitioners and researchers co-produce a Transition Preparation Programme to improve outcomes and experience for young people leaving. Child Adolesc Ment Health 2017; 17: 293
  • 20 Suris JC, Akre C. Key elements for, and indicators of, a successful transition: an international Delphi study. J Adolesc Health 2015; 56: 612-618
  • 21 Singh SP, Paul M, Ford T. et al Process, outcome and experience of transition from child to adult mental healthcare: multiperspective study. Br J Psychiatry 2010; 197: 305-312
  • 22 Koch-Stoecker S, Schulze U. Übergangsmanagement – Probleme und Optimierungsvorschlage aus den Psychiatrischen Institutsambulanzen (PIA). Fortschr Neurol Psychiatr 2019; 87: 619-623
  • 23 Herriger N. Empowerment – Brückenschläge zur Gesundheitsförderung. In: Anonym (Hrsg.) Loseblattwerk Gesundheit: Strukturen und Arbeitsfelder. Neuwied: Luchterhand; 2002: 1-24
  • 24 World Health Organization. Regional Office for Europe & European Commission. Directorate-General for Health and Consumers. User empowerment in mental health: a statement by the WHO Regional Office for Europe – empowerment is not a destination, but a journey. Copenhagen: WHO; 2010
  • 25 Chinman MJ, Linney JA. Towards a Model of Adolescent Empowerment: Theoretical and Empirical Evidence. J Prim Prev 1998; 18: 393-413
  • 26 Clark HB, Jaouich A, Baker K.. The transition to independence process: implementation of the tip model for improving the outcomes of youth and young adults with emotional/behavioral difficulties. In: Cook BG, et al. (eds.). Transition of youth and young adults. Bingley: Emerald Group Publishing; 2015: 135-171
  • 27 Morton M, Montgomery P. Youth empowerment programs for improving self-efficacy and self-esteem of adolescents. Campbell Syst Rev 2010; 06: 1-38
  • 28 Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychol Rev 1977; 84: 191-215
  • 29 Deci EL, Ryan RM. The what and why of goal pursuits: Human needs and the self-determination of behavior. Psychol Inq 2000; 11: 227-268
  • 30 Ringle JL, Ingram S, Newman V. et al Preparing Youth for the Transition into Adulthood: A Process Description, Resid Treat Child Youth. 2008; 24: 231-242
  • 31 Groß LJ, Stemmler M, de Zwaan M. Ressourcenaktivierung in der klinischen Psychologie und Psychotherapie: Überblick über theoretische Hintergründe und aktuelle Forschungsansätze. Fortschr Neurol Psychiatr 2002; 80: 431-440
  • 32 Knight F, Kokanović R, Ridge D. et al Supported Decision-Making: The Expectations Held by People With Experience of Mental Illness. Qual Health Res 2018; 28 (06) 1002-1015
  • 33 Mann M, Hosman CMH, Schaalma HP. et al Self-esteem in a broad-spectrum approach for mental health promotion. Health Educ 2004; 19 (04) 357-372
  • 34 Crews FT, Boettiger CA. Impulsivity, frontal lobes and risk for addiction. Pharmacol Biochem Behav 2019; 93: 237-247
  • 35 Daniel SK, Abdel-Baki R, Hall GB. The Protective Effect of Emotion Regulation on Child and Adolescent Wellbeing. J Child Fam Stud 2020; 29: 2010-2027
  • 36 Berking M, Ebert D, Cuijpers P. et al Emotion regulation skills training enhances the efficacy of inpatient cognitive behavioral therapy for major depressive disorder: a randomized controlled trial. Psychother Psychosom 2013; 82: 234-245
  • 37 Hoffmann GS. Emotion in Psychotherapy. New York: Guilford; 2015
  • 38 Thase ME. Social Skills Training for Depression and Comparative Efficacy Research: A 30-Year Retrospective. Behav Modif 2012; 36: 545-557
  • 39 Ewart CK, Jorgensen RS, Suchday S. et al Measuring stress resilience and coping in vulnerable youth: the Social Competence Interview. Psychol Assess 2002; 14: 339-352
  • 40 Guhn A, Köhler S, Brakemeier E. Kiesler-Kreis-Training: Manual zur Behandlung interpersoneller Probleme. Bern: Beltz; 2019
  • 41 Solomon P. Peer support/peer provided services underlying processes, benefits, and critical ingredients. Psychiatr Rehabil J 2004; 27: 392-401
  • 42 Lindgren E, Söderberg S, Skär L. Managing transition with support: experiences of transition from child and adolescent psychiatry to general adult psychiatry narrated by young adults and relatives. Psychiatry journal 2014; 2014: 457160
  • 43 Moore GF, Cox R, Evans RE. et al School, Peer and Family Relationships and Adolescent Substance Use, Subjective Wellbeing and Mental Health Symptoms in Wales: a Cross Sectional Study. Child Inidc Res 2018; 11: 1951-1965
  • 44 Fukui S, Davidson LJ, Holter M. et al Pathways to Recovery (PTR): Impact of peer-led group participation on mental health recovery outcomes. Psychiatr Rehabil J 2010; 34: 42-48
  • 45 Fukui S, Goscha R, Rapp C. et al Strengths model case management fidelity scores and client outcomes. Psychiatr Serv 2012; 63: 708-710
  • 46 Green CA, Janoff SL, Yarborough BJH. et al The recovery group project: Development of an intervention led jointly by peer and professional counselors. Psychiatr Serv 2013; 64: 1211-1217
  • 47 Styron T, O’Connell M, Smalley W. et al Troubled youth in transition: An evaluation of Connecticut’s special services for individuals aging out of adolescent mental health programs. Child Youth Serv Rev 2016; 28: 1088-1101
  • 48 Haber MG, Karpur A, Deschênes N. et al Predicting improvement of transitioning young people in the partnerships for youth transition initiative: findings from a multisite demonstration. J Behav Health Serv Res 2008; 35: 488-513
  • 49 Ebert DD, Daele T, Nordgreen T. et al Internet and mobile-based psychological interventions: applications, efficacy and potential for improving mental health. A report of the EFPA e-health taskforce. Eur Psychol 2018; 23: 167-187
  • 50 Geirhos A, Klein PJ, Ebert DD. et al Onlinetherapie verringert bestehende Lücken in der Versorgung: Internet- und mobilebasierte Interventionen bei psychischen Störungen. InFo Neurologie Psychiatrie 2019; 21: 36-45
  • 51 Baumeister H, Grässle C, Ebert DD. et al Blended Psychotherapy – verzahnte Psychotherapie: Das Beste aus zwei Welten?. PiD 2018; 19: 51-55
  • 52 Baumeister H, Reichler L, Munzinger M. et al The impact of guidance on Internet-based mental health interventions – a systematic review. Internet Interv 2014; 01: 205-215
  • 53 Domhardt M, Baumeister H. Psychotherapy of adjustment disorders: Current state and future directions. World J Biol Psychiatry 2018; 19: S21-S35
  • 54 Baumeister H, Kraft R, Baumel A. et al Persuasive e-health design for behavior change. In: Baumeister H, Montag C (Hrsg.) Digital Phenotyping and Mobile Sensing. Berlin: Springer Nature 2019: 261-276
  • 55 Domhardt M, Steubl L, Baumeister H. Internet-and mobile-based interventions for mental and somatic conditions in children and adolescents. ZKJPP 2018: 1-14
  • 56 Domhardt M, Schröder A, Geirhos A. et al Efficacy of digital health interventions in youth with chronic medical conditions: A meta-analysis. Internet Interv 2021; 24: 100373
  • 57 Moshe I, Terhorst Y, Philippi P. et al Digital interventions for the treatment of depression: A meta-analytic review. Psychol Bull 2021; 147: 749-786
  • 58 Dülsen P, Bendig E, Küchler AM. et al Digital interventions in adult mental healthcare settings: recent evidence and future directions. Curr Opin Psychiatry 2020; 33: 422-431
  • 59 Weisel KK, Zarski AC, Berger T. et al User Experience and Effects of an Individually Tailored Transdiagnostic Internet-Based and Mobile-Supported Intervention for Anxiety Disorders: Mixed-Methods Study. J Med Internet Res 2020: 22
  • 60 Melville KM, Casey LM, Kavanagh DJ. Dropout from Internet-based treatment for psychological disorders. Br J Clin Psychol 2010; 49: 455-471
  • 61 Baumel A, Faber K, Mathur N. et al Enlight: A Comprehensive Quality and Therapeutic Potential Evaluation Tool for Mobile and Web-Based eHealth Interventions. Journal of medical Internet research 2017; 19 (03) e82