The ESCAP clinical guidance on transition supports care across the child and adolescent mental health service (CAMHS) and adult mental health service (AMHS) boundary throughout Europe. It outlines practices, procedures, and service environments to promote appropriate, safe and timely transition of young people from child and adolescent to adult mental health services or alternative care settings. The guidance addresses planning, decision-making and discharge management at CAMHS and, where needed, continuity in AMHS. The development of the guidance followed established methodological standards for clinical guidance production, combining evidence review, patient and public involvement (PPI), and expert consensus through a structured four-stage process.
The guidance is presented in two parts: Part 1 covers six key domains of transition practice, while Part 2 targets service improvement. Intended primarily for clinicians and service managers and providers, the guidance also offers useful information for young people and their families. To enhance local relevance, countries should adapt recommendations to national service and policy contexts.
The clinical guidance development was led by members of the MILESTONE consortium, a collaborative network established through a European Union-funded research programme (2014–2019) focused on transitional care policies and practices across Europe. The consortium comprises clinicians and researchers from both child/adolescent and adult mental health services across eight European countries: Belgium, Croatia, France, Germany, Ireland, Italy, the Netherlands, and the United Kingdom.
The MILESTONE consortium conducted a comprehensive five-year programme of research exploring transitional care through seven interconnected research strands [16], providing the foundational knowledge base for this guidance development.
Patient and public involvement (PPI) was integral to the guidance development process. Two young people (L.W. and E.J.) and one parent/caregiver (G.A.), all from the United Kingdom with direct experience of mental health service use and transitions, participated as reviewers of the draft guidance document. Their feedback was incorporated through structured review processes, ensuring that the guidance reflects the perspectives and priorities of service users and their families. L.W., a PPI member of the MILESTONE consortium and a Lived Experience Project Support Officer for an NHS Trust, recruited G.A., a Parent Expert by Experience, and E.J., who was part of The Midlands Young Advisors, an autonomous team of young people aged 16–24 from different backgrounds and lived experiences of mental health services.
When adapting this guidance to country-specific service and policy contexts, it is strongly recommended that local PPI members and/or patient advocacy services are actively involved throughout the process.
