Why is the research needed?
Moving from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) can be a difficult and stressful time for young people with eating disorders, as well as for their families, carers and clinicians. This transition often happens around the age of 18, a period when eating disorders may first emerge, become more severe, or require ongoing specialist support. At the same time, young people may also be experiencing major changes in family support, education, living arrangements and clinical care.
Many young people who still need support do not successfully move into adult services after leaving CAMHS. Previous research has shown that only around one-quarter of young people with eating disorders who require ongoing care make the transition to AMHS. Qualitative, cross-sectional and longitudinal studies also show that these transitions can be challenging for young people, carers and healthcare professionals.
Poorly planned transitions may increase the risk that young people disengage from services, experience worsening symptoms, or are left without appropriate care. However, services currently lack a validated way to measure the quality of these transitions from the young person’s perspective. It is important to address this gap to improve service experiences and outcomes.
What are we doing?
Our project is developing the TRIPS Questionnaire, a simple, evidence‑based tool to assess whether young people receive the right support before, during, and after moving from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). It focuses on key aspects of transition quality, including planning, understanding, support, and coordination between services.
First, we will conduct a pilot study to test whether the five areas of the TRIPS framework are linked to eating disorder outcomes. We will recruit approximately 135 young people with eating disorders who have recently transitioned from CAMHS to AMHS. Participants will answer five questions about their transition experience and we will then examine which aspects of transition quality are most strongly linked to better or poorer outcomes.
We will then develop and test the TRIPS Questionnaire through patient and public involvement and engagement (PPIE). Finally, we will build a public-facing website to host the TRIPS Questionnaire alongside accessible information for young people, families, carers, clinicians and services.
How are we working with communities, services and organisations?
We are working closely with communities, services, and organisations through ongoing patient and public involvement. Around 40 young people, carers, and healthcare professionals with lived experience of eating disorders and service transitions are actively shaping the TRIPS Questionnaire, reviewing its content, language, and structure to ensure it is clear, relevant, and useful in practice.
They are supported by advisory groups of young people, carers, and healthcare professionals with experience of supporting young people with eating disorders as they move from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS), who contribute throughout the project to make sure the questionnaire reflects real-world experiences and captures what matters most. We will also engage a wider group of young people in a validation study, helping ensure the tool is meaningful, accessible, and reliable for those who use it.
What will the impact and benefits of this research be?
This research aims to improve how young people with eating disorders are supported when moving from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS).
The potential benefits include helping young people describe and evaluate their transition experiences, supporting families and carers to understand how they can be involved, and enabling clinicians and services to identify what young people need before, during, and after transition. It will also provide services with a practical way to measure and improve transition quality, reduce the risk that young people are lost to follow-up after leaving CAMHS, and inform future improvements in transition pathways for eating disorder care.
In the longer term, the TRIPS Questionnaire could improve continuity of care and support better outcomes for young people with eating disorders. By identifying what good-quality transitions look like, and where support is lacking, the project may help reduce the risk that symptoms become more severe or long-lasting during this critical developmental period.
What do we have planned for knowledge mobilisation and implementation?
The main output from this project will be the TRIPS Questionnaire, a validated measure of transition quality in eating disorder care. The questionnaire will be made available through a public-facing website, alongside information to help young people, families, carers, clinicians and services understand and use it.
Findings from the project will be shared with young people, carers, clinicians, researchers, eating disorder charities and mental health services. We also plan to share findings through academic publications, accessible summaries and future implementation work.
In practice, the TRIPS Questionnaire could be used to support service evaluation, quality improvement and future research. For example, services could use the questionnaire to understand how young people experience transitions, identify areas where transition planning could be improved, and evaluate whether new transition models or initiatives are making a difference.
The findings will also inform future studies examining whether improving one or more TRIPS domains can reduce loss of care and improve outcomes for young people with eating disorders.
Related papers, outputs and resources
Read the related paper, titled 'Transitions from Child and Adolescent to Adult Mental Health Services for Eating Disorders: An In-Depth Systematic Review and Development of a Transition Framework'
Read the related paper, titled 'Eating Disorder Service Transitions: Integrated Models, Knowledge Gaps and Opportunities'
Read the related paper, titled 'Mental Health Service Transition Framework for Predicting Eating Disorder Outcomes In Young People'
Further outputs from this project will include:
- The TRIPS framework
- A public-facing website hosting the TRIPS Questionnaire
Who is involved?
- Anya Ragnhildstveit, University of Cambridge
- Dr Sharon Neufeld, University of Cambridge
- Professor Tamsin Ford, University of Cambridge
Get in contact
Email Dr Sharon Neufeld at sasn2@cam.ac.uk.
Project PEDHSC55
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