This guideline is for district health boards (DHBs) funded infant, child and adolescent mental health (ICAMH), and youth-focused alcohol and other drug (AOD) services. It assists them to develop and implement planning processes for young people who are transitioning from their services.
It has been developed to promote consistent practice across ICAMH/AOD services nationally and to guide services to support young people to transition between services and in-and-out of services based upon their level of need at that time.
To date there has been little research into the benefits of specific models of transition planning. However it is widely acknowledged that processes that enable smooth transitions between services and smooth exits from services are important in supporting recovery and achieving good outcomes for young people accessing these services. Adequate planning is critical in these transitions. Such planning is commonly called ‘discharge planning’ or ‘transition planning’. In these guidelines, we have used the term transition planning because it reflects the intention to ensure a smooth passage into, between, and out of services.
Transition planning ensures that:
- service provision is matched as closely as possible to the needs of the young person and delivered by the most appropriate service/s to meet those needs
- the young person and their family/whānau are the key decision-makers regarding the services they receive
- care is delivered across a dynamic continuum of specialist and primary level services with decisions based on the needs and wishes of the young person and their family/whānau and not service boundaries
- processes are in place to identify and respond early should the young person experience a re‑emergence of any mental health or AOD concern.
The Ministry of Health has an expectation that DHBs and Primary Health Organisations will work together to form Alliance Arrangements.
Transition planning is an individual process that should be personalised to the unique needs and experiences of each young person and their family/whānau. ICAMH/AOD services will need to develop transition planning policies and protocols that incorporate the guidance in this document and address the specific needs of the young people who use their services.
Transition planning template examples are available to download
- My transition plan (docx, 23 KB).
- Transition planning checklist (docx, 22 KB).
- Checklist for service managers and clinical leads (docx, 20 KB).