Abstract：
In a context of international concern about early adult mental health service provision, this study identifies characteristics and service outcomes of young people with attention-deficit hyperactivity disorder (ADHD) reaching the child and adolescent mental health service (CAMHS) transition boundary (TB) in Ireland. The iTRACK study invited all 60 CAMHS teams in Ireland to participate; 8 teams retrospectively identified clinical case files for 62 eligible young people reaching the CAMHS TB in all 4 Health Service Executive Regions. A secondary case note analysis identified characteristics, co-morbidities, referral and service outcomes for iTRACK cases with ADHD (n = 20). Two-thirds of young people with ADHD were on psychotropic medication and half had mental health co-morbidities, yet none was directly transferred to public adult mental health services (AMHS) at the TB. Nearly half were retained in CAMHS, for an average of over a year; most either disengaged from services (40%) and/or actively refused transfer to AMHS (35%) at or after the TB. There was a perception by CAMHS clinicians that adult services did not accept ADHD cases or lacked relevant service/expertise. Despite high rates of medication use and co-morbid mental health difficulties, there appears to be a complete absence of referral to publicly available AMHS for ADHD youth transitioning from CAMHS in Ireland. More understanding of obstacles and optimum service configuration is essential to ensure that care is both available and accessible to young people with ADHD.
摘要：
在国际上关注早期成人精神卫生服务的背景下，这项研究确定了爱尔兰儿童和青少年精神卫生服务(CAMHS)过渡边界(TB)的注意力缺陷多动障碍(ADHD)年轻人的特征和服务结果.iTRACK研究邀请了爱尔兰的所有60个CAMHS团队参加；8个团队回顾性地确定了在所有4个卫生服务执行区域中达到CAMHSTB的62名合格年轻人的临床病例文件。次要案例说明分析确定了特征，合并症,iTRACK伴ADHD病例的转诊和服务结果(n=20)。三分之二的患有多动症的年轻人服用精神药物，一半患有精神健康合并症，然而，在结核病中，没有人直接转移到公共成人精神卫生服务机构(AMHS)。近一半被保留在CAMHS，平均超过一年；大多数人在结核病发生时或之后退出服务（40％）和/或主动拒绝转移到AMHS（35％）。CAMHS临床医生认为成人服务不接受ADHD病例或缺乏相关服务/专业知识。尽管药物使用率很高，精神健康困难也很常见，对于爱尔兰从CAMHS过渡的多动症青年，似乎完全没有推荐公开的AMHS。对障碍和最佳服务配置的更多了解对于确保患有多动症的年轻人既可以获得也可以获得护理至关重要。
