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.

This review looked at what makes it hard or easier for autistic teens and those with ADHD to move from children's mental health services to adult services. Main problems included poor communication between services and unclear processes. Young people did better when they were involved in decisions about their care and had doctors who understood their specific needs. More research is needed on the experiences of neurodivergent young people themselves.

This scoping review examined barriers and enablers to transitioning from child to adult mental health services for autistic young people and those with ADHD. Ten studies were analyzed, revealing predominantly institutional-level barriers including poor communication between services and unclear role definitions. Key enablers identified were involving neurodivergent young people in decision-making about their care and clinicians adapting approaches to individual needs. The review highlighted significant gaps in understanding community and policy-related transition barriers, and noted that most studies examined provider or carer perspectives rather than the experiences of neurodivergent individuals themselves.

Services should prioritize clear communication protocols between child and adult mental health services. Involving autistic young people and those with ADHD in transition planning is essential. Clinicians require training to adapt their approaches to neurodivergent individuals' specific needs during service transitions.

Only 10 studies were included in the review. Most studies focused on provider or carer perspectives, with limited representation of neurodivergent young people's own experiences. Community and policy-related barriers were largely unexplored, indicating significant knowledge gaps in this area.

Many autistic young people and/or those with attention deficit hyperactivity disorder (ADHD) have co-occurring mental health conditions. These individuals can experience significant challenges when transitioning from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS). However, barriers and enablers to the transition from CAMHS to AMHS are poorly understood for this population. This scoping review sought to synthesise the available evidence on barriers and enablers to the transition from CAMHS to AMHS for autistic young people and/or those with ADHD.

Arksey and O'Malley's six-step framework for scoping reviews was used to map out the evidence available and report the findings with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines (PRISMA-ScR). Electronic databases of Medline, PsycINFO, CINAHL, Scopus and ProQuest Central were searched for relevant studies published in English with no date limitations. The review included studies that focused on young people with a primary diagnosis of autism spectrum disorder (ASD) and/or ADHD (population) and their care transition barriers and/or enablers (concept) from CAMHS to AMHS (context). A socioecological framework informed data extraction and narrative synthesis of data on barriers and enablers to transition.

This review identified 1677 studies, of which 66 proceeded to full-text screening, and 10 were included. Most studies focused on institutional-level transition barriers, including poor communication between CAMHS and AMHS and lack of clarity about their role in the transition process. Involvement of the neurodivergent young person in decision-making processes about their mental health care and clinicians who tailored their approaches to the needs of the neurodivergent young person emerged as key enablers of a positive transition experience. Studies largely failed to examine community and policy-related barriers to mental health care transitions.

Most studies examined the perspectives of providers or carers, with only five representing the perspectives of neurodivergent people. Young people who are autistic and/or have ADHD experience many barriers to their transition from CAMHS to AMHS; however, few studies have examined barriers and enablers to the service transition process.