Validation of the Transition Readiness and Appropriateness Measure (TRAM) for the Managing the Link and Strengthening Transition from Child to Adult Mental Healthcare in Europe (MILESTONE) study
Fiona McNicholas,
Dieter Wolke,
Jason Madan,
Jatinder Singh,
Federico Fiori,
Paramala Santosh,
Jane Warwick,
Helena Tuomainen,
Swaran Singh,
Laura Adams,
Mathilde Mastroianni,
Natalie Heaney,
Kate Lievesley,
Ilyas Sagar-Ouriaghli,
Giovanni Allibrio,
Rebecca Appleton,
Nikolina Davidović,
Giovanni de Girolamo,
Gwen Dieleman,
Katarina Dodig-Ćurković,
Tomislav Franić,
Charlotte Gatherer,
Suzanne Gerritsen,
Elisa Gheza,
Lidia Manenti,
Athanasios Maras,
Francesco Margari,
Adriana Pastore,
Moli Paul,
Diane Purper-Ouakil,
Francesco Rinaldi,
Vehbi Sakar,
Ulrike Schulze,
Giulia Signorini,
Cathy Street,
Priya Tah,
Sabine Tremmery,
Amanda Tuffrey,
Frank Verhulst,
Anna Wilson
Affiliations
Fiona McNicholas
School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
Dieter Wolke
20 Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
Jason Madan
4 University of Warwick, Warwick Medical School, Coventry, Warwick, UK
Jatinder Singh
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King`s College London, London, UK
Federico Fiori
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King`s College London, London, UK
Paramala Santosh
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King`s College London, London, UK
Jane Warwick
King’s Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King`s College London, London, UK
Helena Tuomainen
9 National Institute for Health and Care Research, Applied Research Collaboration (ARC) West Midlands, University of Warwick, Coventry, UK
Swaran Singh
Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
Laura Adams
Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California San Diego, San Diego, California, USA
Mathilde Mastroianni
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King`s College London, London, UK
Natalie Heaney
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King`s College London, London, UK
Kate Lievesley
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King`s College London, London, UK
Ilyas Sagar-Ouriaghli
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King`s College London, London, UK
Giovanni Allibrio
Unit of Neuropsychiatry, ASST Spedali Civili di Brescia Dipartimento di Salute Mentale, Brescia, Lombardia, Italy
Rebecca Appleton
1 NIHR Mental Health Policy Research Unit, UCL, London, UK
Nikolina Davidović
University Hospital Center Split, Split, Croatia
Giovanni de Girolamo
Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
Gwen Dieleman
3 Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
Katarina Dodig-Ćurković
Faculty for Dental Care and Health, Osijek, Croatia
Tomislav Franić
7 Department of Psychiatry, Clinical Hospital Center Split, Split, Croatia
Charlotte Gatherer
Warwick Medical School, University of Warwick, Coventry, UK
Suzanne Gerritsen
3 Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
Elisa Gheza
Neuropsychiatry Service of Childhood and Adolescence, Mental Health Department, ASST della Valcamonica, Breno, Lombardia, Italy
Lidia Manenti
Unit of Neuropsychiatry, ASST Spedali Civili di Brescia Dipartimento di Salute Mentale, Brescia, Lombardia, Italy
Athanasios Maras
4 Yulius Academy, Yulius Mental Health Organization, Dordrecht, The Netherlands
Francesco Margari
Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Puglia, Italy
Adriana Pastore
Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Puglia, Italy
Moli Paul
Warwick Medical School, University of Warwick, Coventry, UK
Diane Purper-Ouakil
Hôpital Saint Eloi, Médecine Psychologique de l’Enfant et de l’Adolescent, Centre Hospitalier Regional Universitaire de Montpellier, Montpellier, Languedoc-Roussillon, France
Francesco Rinaldi
Neuropsychiatry Service of Childhood and Adolescence, Mental Health Department, ASST della Valcamonica, Breno, Lombardia, Italy
Vehbi Sakar
Department of Child and Adolescent Psychiatry/Psychotherapy, Universitatsklinikum Ulm, Ulm, Baden-Württemberg, Germany
Ulrike Schulze
Department of Child and Adolescent Psychiatry/Psychotherapy, Universitatsklinikum Ulm, Ulm, Baden-Württemberg, Germany
Giulia Signorini
IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
Cathy Street
Warwick Medical School, University of Warwick, Coventry, UK
Priya Tah
Warwick Medical School, University of Warwick, Coventry, UK
Sabine Tremmery
15 Department of Neurosciences, KU Leuven, Leuven, Belgium
Amanda Tuffrey
Warwick Medical School, University of Warwick, Coventry, UK
Frank Verhulst
Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
Anna Wilson
2University of Glasgow Medical School, Glasgow, UK
Objective Young people moving from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) are faced with significant challenges. To improve this state of affairs, there needs to be a recognition of the problem and initiatives and an urgent requirement for appropriate tools for measuring readiness and outcomes at the transfer boundary (16–18 years of age in Europe). The objective of this study was to develop and validate the Transition Readiness and Appropriateness Measure (TRAM) for assessing a young person’s readiness for transition, and their outcomes at the transfer boundary.Design MILESTONE prospective study.Setting Eight European Union (EU) countries participating in the EU-funded MILESTONE study.Participants The first phase (MILESTONE validation study) involved 100 adolescents (pre-transition), young adults (post-transition), parents/carers and both CAMHS and AMHS clinicians. The second phase (MILESTONE cohort study and nested cluster randomised trial) involved over 1000 young people.Results The development of the TRAM began with a literature review on transitioning and a review of important items regarding transition by a panel of 34 mental health experts. A list of 64 items of potential importance were identified, which together comprised the TRAM. The psychometric properties of the different versions of the TRAM were evaluated and showed that the TRAM had good reliability for all versions and low-to-moderate correlations when compared with other established instruments and a well-defined factor structure. The main results of the cohort study with the nested cluster randomised trial are not reported.Conclusion The TRAM is a reliable instrument for assessing transition readiness and appropriateness. It highlighted the barriers to a successful transition and informed clinicians, identifying areas which clinicians on both sides of the transfer boundary can work on to ease the transition for the young person.Trial registration number ISRCTN83240263 (Registered 23 July 2015), NCT03013595 (Registered 6 January 2017); Pre-results.
