The transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) represents a vulnerable period in psychiatric care, often characterised by care discontinuities and high dropout rates. Despite up to 45% of young people requiring continued treatment, few receive adequate continuous care. In 2018, only two of 28 European countries reported having formal transition guidelines in place. In Austria, professionals mostly rate the system as insufficient and highlight the need for structured protocols, interprofessional collaboration, and clear legal and organisational frameworks.

This report systematically analysed international models and strategies of transitional psychiatry, focusing on service organisation, implementation strategies, and resource allocation. A structured document search identified guidelines, frameworks, and policies, which were appraised using an adapted AGREE II instrument. Data were extracted within a combined deductive–inductive framework and synthesised narratively. Expert consultations complemented the review to address missing data and validate findings for the Austrian context.

International models converge around several key principles: developmentally appropriate and individualised transitions, cross-sectoral planning, flexible age limits, shared documentation, transition coordinators, and structured follow-up. Person-centred approaches, including psychoeducation, youth and parents/carers involvement, and digital tools, are emphasised to promote autonomy and reduce disengagement. However, implementation is hindered by workforce shortages, restrictive eligibility criteria, and fragmented financing. Indication-specific evidence highlights limited capacity and expertise for adult services for specific indications, misaligned eligibility criteria, reduced support intensity after transfer, the need to address stigma, and the need for tailored psychoeducation and awareness-raising.

Overall, the findings highlight the need to replace reactive, age-based transfers with proactive, structured, youth-centred processes. Despite the emerging consensus, systematic evaluations remain limited. Methodological rigour is lacking, and key issues such as sustainability, resources, and cross-sectoral integration require further examination. In Austria, transitional psychiatry is still in its early stages, with recent legislative steps, such as raising the CAMHS age limit, constrained by staffing and infrastructure shortages. Experts identified structural barriers such as limited workforce capacity, fragmented reimbursement systems, and the absence of transition-specific services in the national health services catalogue (Leistungskatalog). Sustainable implementation will require dedicated resources, systemic alignment across service sectors, and robust evaluation and research.

International evidence offers an evidence-based foundation, but no one-size-fits-all model. The findings presented here provide guiding principles for developing a coherent, youth-centred, and evidence-based framework for transitional psychiatry in Austria.