Mind the Gap: Parental Perspectives on Mental Health Service Transitions for Young Adults with Anorexia Nervosa

Introduction: The transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) is known to be difficult. For young persons (YP) with anorexia nervosa (AN) transitioning between services might be particularly challenging due to the timing, often coinciding with other key life changes. The potential consequences of inadequate transition are many: treatment dropout, heightened symptom load, and increased distress amongst patients and relatives. Furthermore, the parent-child relationship may be affected by the changes related to service transition. Parents are highly involved in treatment in CAMHS, but have a less central role in AMHS, therefore, their experience of transition is important to fully grasp potential problems or shortcomings of the transition processes and thereby improve it. The parental voice has not received much attention to date. This study aimed to describe common themes in parental experiences of their role, when their YP transitions from CAMHS to AMHS. Methods A total of seven parents were included, three fathers, three mothers and one stepmother. Parents were interviewed using a semi-structured interview guide focused on their experiences of the transition process. The data was analyzed using empirically testing thematic analysis. Results The analysis revealed 3 superordinate themes relating to the parental experience of transition: 1) The transition process, 2) Autonomy and independence, and 3) Shift in parental role. The parents´ overall experience of the transition process was that it was unsatisfactory, and in their view a cause of increased anxiety and a worsening of symptoms in the YP. Furthermore, parents described feeling anxious and uncertain regarding the new personal and legal autonomy and independence that the YP had in the AMHS. Finally, the large shift in parental role was challenging, although, for some it improved the parent-child relationship. Discussion parents can be highly affected by the transition process and the shift in involvement, and the parent-child relationship can both improve or strain in this phase. Furthermore, several parents experienced their child having adverse outcomes of the transition process or lack thereof. Future research can benefit from including parental perspectives on transitioning in healthcare for YP with AN.