Moving from child to adult mental health services

A guide on what to expect when moving from child to adult mental health services and what do do if things don't go the way they should.

What to expect

Moving from CAMHS (Children and Adolescent Mental Health Services) to Adult Mental Health Services, sometimes called 'transition', can feel like a really worrying and uncertain time.

We’re here to help you understand what should happen and where to find support if you’re having any problems.

We have information on:

What are CAMHS?

Child and Adolescent Mental Health Services (CAMHS) are services that support young people with their mental health.

On this page when we talk about CAMHS, we are referring to the free services run by the NHS, sometimes called Specialist CAMHS.

In some areas, your local CAMHS service may be called another name. If you’re not sure, you can ask at your doctors surgery.

What are Adult Mental Health Services

Adult Mental Health Services are specialist NHS services that support adults with mental health problems.

When will I leave CAMHS?

You will normally leave CAMHS when you turn 18, but in some places it can be earlier or later. This depends on the service and the type of support you're getting.

If you're not sure, you can ask your CAMHS team at any time.

What happens when I leave?

When you leave CAMHS, your CAMHS team will either:

refer you to Adult Mental Health Services for an assessment to see whether they can offer you support.
direct you to other adult support services like your doctor, social services or charity organisations.
discharge you. This means that, if you are well enough, their support will end. If they do this, they will give you information on other support that might help and what to do if things get worse.

What should happen before I leave CAMHS?

If you’re being referred to any adult service, your CAMHS team should start planning this at least 6 months before you leave. They should:

Give you information to understand the process of moving to adult services and what support will be available.
Involve you in the planning process and listen to your views.
Put one person in charge of managing your move from CAMHS.
Prepare a plan of what you need and what support you will receive when moving to adult services.

Your CAMHS team should talk all of this through with you and any referral to adult services should be made before you leave CAMHS.

Moving to Adult Mental Health Services

England and Wales have slightly different rules and processes if you're moving from CAMHS to Adult Mental health Services. There can be also big differences in the way different CAMHS manage the move. But you should always be told about what to expect and have your views listened to.

Although this information says what should happen when you move from CAMHS to Adult Mental Health Services, sometimes it doesn't go the way it should.

Read our page on 'Problems I might face' for information about what to do if this happens.

England and Wales have slightly different rules and processes if you're moving from CAMHS to Adult Mental health Services. There can be also big differences in the way different CAMHS manage the move. But you should always be told about what to expect, and have your views listened to.

England

If you're moving to Adult Mental Health Services, you should be under something called the 'Care Programme Approach' (CPA). This is a package of support provided by the NHS for people who have a mental health problem.

This means you should have:

a care co-ordinator – this is someone who manages your care and is the person to contact if you have questions
a care plan – this says what treatment and support you need, who will provide that support, and the support you might need in a crisis. You should be given a written copy of this plan.

If you have a CPA care plan, it will not end when you move to Adult Mental Health Services. It will only end when you and your mental health team believe it is no longer needed.

If you're not sure whether you're under the CPA plan, or have not been given a written copy of your care plan, you should speak to someone in your CAMHS team.

Wales

When moving to Adult Mental Health Services, you should be given:

a transition worker – someone who manages and supports your move to adult services and helps you put together a 'Young Person’s Passport'.
a 'Young Person’s Passport' – this is for you to fill out, explaining what's important for you and want support you want.
a Care and Treatment plan – a written plan, put together by your Care and Treatment co-ordinator and agreed with you. It explains things that you would like to achieve and what support you need from mental health services to do this.

If you're discharged from CAMHS and not referred to Adult Mental Health Services, but feel your mental health is getting worse, you have a legal right to ask Adult Mental Health Services to reassess you. You can ask for this when you turn 18 (as long as you have left CAMHS in the last 3 years) and you don’t have to speak to your doctor first.

When CAMHS discharge you, they must give you written information about your right to a reassessment.

"My CAMHS team were really good at helping me get support from adult services but the transition from child to adult services still felt like a really big change."

What happens when I'm referred to Adult Mental Health Services?

When Adult Mental Health Services get your referral from CAMHS, they will need to find out about the support you need and decide whether their service is right for you. They can do this by:

looking at your medical notes (the information held about you from CAMHS and your doctor)
speaking to your CAMHS team
speaking to your parents
meeting with you and listening to what support you want.

If there are specific things you want them to know, you should ask the person managing your move to adult services about the best way to tell them.

If they think their service is right for you, they will get in touch to give you an appointment.

What if Adult Mental Health Services won't help me?

Sometimes, based on your referral and finding out what support you need, adult services might say that they can't offer you support. If this happens, they should explain why and tell you where else you can go for support.

If you don’t agree with their decision, you can:

speak to your CAMHS team to find out what you can do.
see our page on ‘problems I might face’ for information on things you could try.

How will my parents or carers be involved?

CAMHS encourages families and carers to be involved in your care. When moving to adult services you should be asked how you want your parent or carer to be involved, and what you say should be respected.

How are adult services different?

Every mental health service is slightly different but some people find that Adult Mental Health Services can be quite different from CAMHS.

You might find:

the relationship with your mental health team is different.
you receive more or less support than before.
there are different support and treatment options.
you're in groups with adults a lot older than you.
adult services might speak to your family and caregivers less than CAMHS. If you still want your family to be involved, you should make this clear.
adult services might focus more on your diagnosis.

The difference between child and adult services can sometimes feel quite scary and overwhelming. See our page on ‘What I can do’ for ideas of things that might make things feel a little easier.

To find out about the support options available when you turn 18, you can see our guide on seeking help for adults.

What happens if I turn 18 whilst I’m in hospital?

If you're staying in hospital as an in-patient, planning to move to adult services should start 6 months before you turn 18. The plan should explain what happens when you turn 18, like:

being moved to an adult ward – as hospital wards are split into adolescent and adult wards.
discharged – if you are well enough.

Sometimes you might be allowed to stay on the adolescent ward until you're discharged, but this depends on the hospital.

What if I’ve been sectioned in the past?

Sectioning is when you are kept in hospital under the Mental Health Act 1983. You can be sectioned if you are at risk of hurting yourself, or to protect other people.

Sometimes being sectioned gives you a legal right to support. If you have been sectioned under section 3, 37, 47 or 48, you have a legal right to support called section 117 aftercare.

Section 117 support will be personal to you, depending on what support you need to stop your mental health from getting worse. This right to support doesn't end when you leave CAMHS so your legal right to the support you need will not change when you move to adult services.

"In a strange sort of way, I was lucky. I had a legal right to treatment with adult services, and a team of professionals fighting my corner."

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