Transition to Adult Care for Youth with Severe Mental Illness: Does Continuity with Primary Care Matter?

Objective: To analyze the association between primary care continuity and acute mental health care services following transition to adult care. Methods: Population-based retrospective cohort study using linked administrative health data of youth ages 12-17 with schizophrenia (SZ), eating disorders (ED), or mood and affective disorders (MAD) admitted between April 1, 2002 and April 1, 2010 in Ontario, Canada. Poisson regression models tested the association of primary care continuity and mental health outcomes after transition. Results: Among 3183 youth with severe mental illness, the majority (n=2,052, 64.5%) received continuous primary care during the transition period. Compared with continuous care, no primary care (n=190) during transition was associated with a 52% increased risk of a mental health admission following transition (aRR 1.52, 95% CI 1.12, 2.05). Conclusions: In the context of decreasing specialist mental health visits, ensuring adequate access to primary care during the transition period may improve outcomes in young adulthood.M.Sc