Krista Sferrazza: Improving youth transitions to adult mental health services

Student Spotlight

In brief

As part of a clinical placement assignment during the third year of her Bachelor of Nursing studies, Krista conducted a literature review to understand the issues and gaps that result in difficult transitions from child and adolescent mental health services to adult mental health services. She found a number of barriers, including differing philosophies of care, lack of training to work with youth in transition, poor communication between health care providers, inadequate coordination among agencies, and cultural differences. 

In our latest Student Spotlight, EENet's Rossana Coriandoli profiles Krista Sferrazza. Student Spotlights are brief profiles of up-and-coming student researchers.

About Krista

Krista is in her fourth year in the Nursing program at McMaster University, in  Hamilton, Ontario. She has a passionate interest in paediatrics and hopes to work in a paediatric mental health setting. She would like to continue her studies at the graduate level in research and clinical leadership. She was elected president of the McMaster University Nursing Students Society for 2015-2016, and loves being involved in student life. She is also an active volunteer for the Hamilton Health Sciences Volunteer Association, volunteering at McMaster Children’s Hospital.

What is Krista’s research about?

During her clinical placement in acute psychiatry, Krista witnessed many adolescents who were receiving treatment in an adult in-patient psychiatric setting. 

“It’s alarming, the lack of transitional supports in place to facilitate a successful transition for children and adolescents with mental illness and their families,” she noted.

“I was interested in undertaking research on this topic as many of my patients were the same age as me, but at the same time were totally different,” she added. 

“The idea first struck me, when I had an autistic patient that was an adult but functioned at the age of a 12-year-old. This situation made me question how our adult mental health services are not catered to him or his developmental needs as a child or adolescent setting would. However, because of his age, he had to make the transition from child mental health services to adult mental health services regardless of his developmental age.” 

For this reason, Krista focused her research to understand the issues and gaps that result in difficult transitions from child and adolescent mental health services to adult mental health services.

About the project

Krista performed a review of published information looking at adolescents and youth who received child and adolescent mental health services and who, due to their age, transitioned to adult mental health services. 

The search included presentations and published reports by government ministries and agencies/organizations specializing in mental health. Most of the published reports she found were based out of Ontario, but she also included reports from the United Kingdom.

She began this research in October 2014 and updated it in January 2015. She hopes to keep the review as up to date as possible, so she’s continually investigating new research in this area. 

What she found

There are a number of barriers to making a successful transition for youth and their families. These barriers can be separated into potential and systemic barriers. Her work focused on potential barriers. 

These included differing philosophies of care, lack of training to work with youth in transition, poor communication between health care providers, inadequate coordination among agencies, and cultural differences. 

Krista said that these barriers result in a higher risk of youth disengaging from services. To facilitate a successful transition from youth to adult services, it may be helpful to implement the shared management model, which is currently being used with children with chronic illness. This model of care describes the development of an early therapeutic alliance between children/youth, families and health care providers. 

Other recommendations that Krista identified include using a transition worker to meet the family’s individual needs. Also, it might be useful to use liaison meetings and interagency dialogue, and providing education for professionals to learn to work with youth in transition. 

What’s next for Krista?

Krista presented a poster of this research at the Canadian Nursing Students Association National Conference in Regina, SK, in January 2015. Although this literature review has not yet been published, she is networking and seeking out individuals to help get this work published. 

She will be sharing her poster presentation at the Canadian Federation of Mental Health Nurses in Niagara Falls, ON, in October of 2015, and has been accepted to present her poster at the Children’s Mental Health Ontario National Conference in Toronto, ON, in November of 2015. 

She hopes to continue updating this review with up-to-date literature, and seeking out opportunities to contribute to childhood and adolescent mental health research. 

She also plans to explore this research in graduate studies by conducting a phenomenological, qualitative study that would explore the lived experience of youth and their families who are going through transition from child and adolescent mental health services to adult mental health services. 

With personal testimonials, she hopes that recommendations to address barriers within the system and within agencies may be integrated into mental health services and health professional practice. 

For more information contact Krista at sferrak [at] mcmaster [dot] ca.

Sign up for our Newsletter