Access to Treatment for Adolescents with Substance Use and Co-Occurring Disorders: Challenges and Opportunities

Autor/inn/en	Sterling, Stacy; Weisner, Constance; Hinman, Agatha; Parthasarathy, Sujaya
Titel	Access to Treatment for Adolescents with Substance Use and Co-Occurring Disorders: Challenges and Opportunities
Quelle	In: Journal of the American Academy of Child & Adolescent Psychiatry, 49 (2010) 7, S.637-646 (10 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0890-8567
DOI	10.1016/j.jaac.2010.03.019
Schlagwörter	Integrated Services; Substance Abuse; Intervention; Mental Health; Psychiatry; Adolescents; Public Policy; Access to Health Care; Literature Reviews; Barriers; Economic Factors; Alcohol Abuse; Drug Abuse; Health Services; Delivery Systems; Financial Support; Health Insurance; Grants; Social Services + Suchen Sie Ihr Suchwort? Drug use; Drug consomption; Drogenkonsum; Psychohygiene; Psychiatrie; Adolescent; Adolescence; Adoleszenz; Jugend; Jugendalter; Jugendlicher; Öffentliche Ordnung; Ökonomischer Faktor; Health service; Gesundheitsdienst; Gesundheitswesen; Auslieferung; Finanzielle Förderung; Krankenversicherung; Grant; Finanzielle Beihilfe; Social service; Soziale Dienstleistung; Soziale Dienste
Abstract	Objective: To review the research on economic and systemic barriers faced by adolescents needing treatment for alcohol and drug problems, particularly those with co-occurring conditions. Method: We reviewed the literature on adolescent access to alcohol and drug services, including early intervention, and integrated and specialty mental health treatment for those with co-occurring disorders, examining the role of health care systems, public policy (health reform), treatment financing and reimbursement systems (public and private), implementation of evidence-based practices, confidentiality practices, and treatment costs and cost/benefits. Results: Barriers to treatment, particularly integrated treatment, are largely rooted in our organizationally fragmented health care system, which encompasses public and private, carved-out and integrated systems, and different funding mechanisms (Medicaid versus block grants versus private insurance that include "high deductible" plans and other cost controls.) In both systems, carved-out programs de-link services from other mental health and general health care. Barriers are also rooted in disciplinary differences and weak clinical linkages between psychiatry, primary care and substance use, and in confidentiality policies that inhibit communication and coordination, while protecting patient privacy. Conclusion: In this era of health care reform, we have the opportunity to increase access for adolescents and develop new models of integrated services for those with co-occurring conditions. We discuss opportunities for improving treatment access and implementation of evidence-based practices, examine implications of health reform and parity legislation for psychiatric and substance use treatment, and comment on key unanswered questions and future research opportunities. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10