Mental health care and the transition to adulthood

The tragic story of Edward Mallen, who committed suicide in Cambridgeshire after being told he would have to wait five days to see a mental health doctor despite suffering from depression and suicidal thoughts, brings into focus important and complex issues around the treatment of young people who are transitioning from adolescence into adulthood.

Edward was, like many 18 year olds, referred to adult services. However, young people - even if ‘an adult’ in the eyes of the law - are still vulnerable and need treatment which acknowledges that when you turn 18 you don't suddenly change or become more resilient.

Dr Andy Wiener, a Child and Adolescent Psychiatrist from CSG member Tavistock and Portman NHS Foundation Trust, explains that the Commissioners of mental health services in Camden have agreed to allow the Tavistock to keep young people in CAMHS beyond their 18th birthday, if that is what meets their needs best.

“The Tavistock has developed specialist adolescent services which see young people until they are 25, and Child and Adolescent Mental Health Services (CAMHS) which work in collaboration with other NHS and voluntary partners to ensure they can 'mind the gap' for young people in transition. We recognise this is a point of vulnerability and an area which needs particular care and attention to ensure people are kept safe”, says Andy.

Camden, like the rest of the UK, has seen a sharp increase in the number and severity of mental health related admissions for young people in recent years. Across England and Wales, it’s now estimated that one in every three children in a classroom has a mental health problem and the number of young people needing specialist services is on the rise.

“Across the NHS more needs to be done to ensure that the networks around young people are geared up to detect and prevent mental illness - it's why the outreach work, training and supervision delivered at the Tavistock and Portman and at other London Trusts is so critical”, continued Andy. “It means GPs, teachers, youth workers, social workers and a whole host of other professionals can build capacity in their ability to work with young people at risk and detect issues before they get too serious.”

“Edward's case is a tragic reminder of how important it is to ensure joined up working - it points to the need for GPs and mental health professionals across child and adult services to work together. In Camden, this is being achieved by providing training to adult mental health staff and by having 'CAMHS Champions' working in adult mental health services.”

“We need to see a culture change in adult services. Only when services are joined up and working together can children and young people get the support they really need. It's also the only way to ensure we provide adequate services which help to stop these tragic events from happening in the future.”

Andy Wiener recently spoke on BBC Radio 4’s Today Programme on this issue. You can hear the interview with Andy and Edward Mallen’s father here (at 1 hour 48 minutes) and read Andy’s full blog by visiting the Tavistock and Portman website.


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