Almost all facilities that treat significant numbers of children and adolescents for substance abuse conduct comprehensive substance abuse assessments (97 percent). However, only half of these facilities also conduct comprehensive mental health assessments according to a study sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) published in the July, 2006 issue of the Journal of Substance Abuse Treatment.

SAMHSA's National Survey on Drug Use and Health shows that 5.3 percent of adolescents ages 12-17 meet criteria for drug dependence or abuse, and among those with illicit drug dependence or abuse, 14.5 percent have had a major depressive episode within the past year. SAMHSA recommends that treatment of adolescents should address psychiatric, medical, family and environmental problems as well as substance abuse.

"Over the past few years, the systems of services that promote recovery from substance abuse and mental illnesses have evolved in exciting ways," SAMHSA Administrator Charles Curie said. "Clearly we have made great strides towards the day when co-occurring substance use and mental disorders are the expectation. However, this report points out we have yet to achieve a system that allows any door to be the right door for the services an individual needs."

The study uses data from SAMHSA's 2003 National Survey of Substance Abuse Treatment Services to determine if treatment centers were following best practice recommendations for the field. The study, written by researchers from ThomsonMedstat and SAMHSA, found that only half of facilities offered special programs for adolescents suffering co-occurring mental and substance use disorders.

The study did determine, however, that many facilities were conducting discharge planning and providing aftercare, counseling and relapse prevention groups, all strongly recommended. Discharge planning identifies and relates client needs to community resources, ensuring the supports needed to sustain the progress achieved in treatment. Aftercare is the stage following discharge in which the patient functions with a self-directed plan that is monitored by a substance abuse counselor.

The SAMHSA-funded study was conducted under the SAMHSA Spending Estimates Project and written by Tami Mark, Xue Song, and Rosanna Coffey of ThomsonMedstat, Rita Vandivort, Sarah Duffy and Jutta Butler of SAMHSA, and Vernon Shabert of Integral Health Decisions. The article can be accessed at www.journals.elsevierhealth.com/periodicals/sat.

SAMHSA, a public health agency within the U.S. Department of Health and Human Services, is the lead federal agency for improving the quality and availability of substance abuse prevention, addiction treatment and mental health services in the United States.