Peer mentoring and youth transition to adult care
Transitioning from paediatric care into adult health services can bring unfamiliar clinics, new paperwork and anxiety for young people with chronic illnesses. In Australia, the handover often occurs around ages 16 to 18, although timing depends on the condition, development and local service availability. Good transition care addresses treatment, daily self-management and social confidence together.
Peer mentoring improves transition to adult services for youth with chronic illnesses by connecting each participant with a trained person who has navigated similar care. Mentors offer practical advice and reassurance; clinicians remain responsible for treatment and safety. This relational support strengthens transition readiness while helping young people build lasting independence.
Peer mentoring in the transition journey
Peer mentoring works best as part of a coordinated pathway, not an optional service offered on discharge day. Referrals can begin before the final paediatric appointment so pairs can meet, visit an adult clinic, practise booking care and identify barriers. In Brisbane, young people may move between the Queensland Children’s Hospital and services at Royal Brisbane and Women’s Hospital, the Mater or Princess Alexandra, alongside a local GP. Regional Queensland pathways may depend more heavily on telehealth and travel support.
The Brisbane Diamantina Health Partners network is well placed to support this work because it connects research institutes, universities and health services. Collaborative work can support shared training, consumer expertise and evaluation across different settings. Peers can explain adult appointments, help organise medication and referral information, and rehearse questions without speaking for the young person. Their credibility comes from lived experience, while the clinical team remains the source of medical advice.
What makes peer support work
An effective mentor brings more than a shared diagnostic label. Training should cover communication, boundaries, safeguarding, escalation and the limits of confidentiality. Regular supervision gives mentors a safe place to discuss difficult situations and ensures the relationship does not rest on informal promises that cannot be maintained.
Matching should be individualised. Some young people prefer an older mentor with established routines; others want someone closer in age, gender, cultural background or communication style. One-to-one meetings, group sessions, text check-ins and telehealth can coexist, with the mentee choosing what feels safe. A planned review after the first adult appointment helps preserve momentum.
Family support can assist, but the young person’s preferences should guide it. Mentors can explain why appointments matter and offer a contact between visits. Consent should be discussed in plain language, including who can see notes or messages and when information must be shared for safety. This respects adolescents while recognising the important role of carers, GPs and specialists.
Benefits for wellbeing and clinical care
The first gains programs commonly report concern confidence. Young people become more willing to ask questions, recognise warning signs, negotiate with clinicians and make decisions about care. Peer relationships can reduce isolation when a young person is leaving school, changing jobs or moving away from familiar friends. Older mentors also model how to balance treatment with study, work and relationships, making day-to-day management feel more ordinary.
Social connection is a health resource, not a decorative addition. Community histories such as the founding members’ story offer a parallel: belonging and trusted relationships can support people through change. In a mentoring program, repeated contact and genuine respect can bridge the paediatric and adult worlds, especially where a formal service has not yet built that connection.
Peer support may improve engagement and continuity of care, but outcomes should be tested rather than assumed. Services can track appointment attendance, self-management confidence, wellbeing, understanding of medication and care plans, and whether participants feel heard. A program may help some conditions or communities more than others. Consumer-led evaluation, including feedback from young people who leave, should guide refinement and expose inequitable access.
Designing a safe Australian model
Queensland has a mixed health market of public hospitals, private specialists, community organisations and general practices. A young person may need coordinated review by a GP, specialists, allied health professionals and mental health services. A named transition coordinator can stop one referral being arranged while another is missed and strengthen care coordination. In Brisbane, families may travel between hospital precincts by public transport, taxi or car; in regional and remote areas, telehealth, outreach clinics and travel support can determine whether care is accessible.
Privacy and consent must be built into peer support. Personal health information is sensitive, so services must follow the Privacy Act 1988 and Australian Privacy Principles where applicable. For Queensland public health services, the Health Records Act 2001 (Qld) and Queensland Health consent and confidentiality policies also guide how information is managed. My Health Record can assist information sharing, but clear authorisation and access controls remain essential. A mentor should never promise eligibility or advise on Medicare, Pharmaceutical Benefits Scheme or National Disability Insurance Scheme supports without directing the participant to the appropriate service.
The program should be co-designed with the people who use it. Aboriginal and Torres Strait Islander young people, culturally and linguistically diverse families, young people with disability and LGBTQIA+ young people may encounter different barriers to feeling heard. Culturally safe practice, accessible materials, paid mentor roles, flexible meeting places and a documented escalation process for abuse or serious deterioration are core safeguards.
Four recommendations make these principles operational:
- Co-design a pathway with young people and include a peer referral before the final paediatric appointment and through the first adult appointment.
- Train and supervise mentors in lived experience, communication, boundaries, privacy, cultural safety and clinical escalation, and budget for their time.
- Make consent, information sharing and participant choice central to matching and contact, with a documented process for urgent or safeguarding concerns.
- Measure experience and outcomes, seek participant and family feedback, and adapt the program for different conditions and communities.
Building pathways that last
Health services, researchers and community organisations can start with one condition or clinic, appoint a transition coordinator and recruit people with relevant lived experience. A statewide partnership can connect implementation sites with training, evaluation and community partners, creating a route from a promising idea to sustained care.
Connect with Brisbane Diamantina Health Partners to identify collaborating teams, then bring the young person, peer mentor, transition coordinator and relevant clinician into one planning meeting. Build the pathway around the young person’s goals and keep their voice central to every decision that follows.
