Will Transition Services in Psychiatry be an added value? Perspective of Child & Adolescent and Adult psychiatrists in Portugal (A qualitative study)

Background: The transition from paediatric health to adult services is not a simple process, it has several vicissitudes that often compromise its success, breaking the continuity of care. Although common in many medical specialties, this issue is particularly important in mental health, and the literature tell us that there is not enough research on it. This study aims to characterize the perceptions about this subject of Portuguese physicians who most directly intervene in the process (C&A and adult psychiatrists), the associated difficulties and the possibilities of improvement to be introduced into the system. Methods: : A qualitative methodology was used, through semi-structured interviews, allowing for the approach of topics not anticipated by the interviewer. A convenience sample was evaluated, consisting of psychiatrists from public health sector, in the Lisbon region; the number of physicians to be interviewed was not established at the outset, which was determined by the "Saturation", a point from which no opinions different from those that have already emerged. Results: : The data collected shows that two thirds of the interviewees consider that it would be useful to have transition services, while the others think that these services would be useless, not bringing improvement in the quality of care. All agree that it would be advantageous to have transition strategies that would improve communication between paediatric and adult services. Informal transfer was the one that produced the best results, given the lack of transition protocols. Conclusions: : Many young people move to an adult service informally, depending on the success of the commitment of doctors, family, and patients. Another way often used is the clinical discharge for GP’s, who decides on referral to Psychiatry. Formal and standardized service transitions were not found. The importance of a transition without rupture in the continuity of care is recognized by all participants. Some of them acknowledged that this was an issue on which they had not previously reflected. This shows that the reality in Portugal is similar to other countries, with not enough awareness of the importance of this process in the patient's prognosis.