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Assessing the Impact of Childhood Interventions
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Barbara J. Burns, Ph.D.
Scott N. Compton, Ph.D.
Helen L. Egger, M.D.
Elizabeth M.Z. Farmer, Ph.D.
E. Jane Costello
Tonya D. Armstrong
Alaattin Erkanli
Paul E. Greenbaum
Chi-Ming Kam
Linda M. Collins
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Service Use Among Adolescents With Comorbid Mental Health and Substance Use Disorders

Paul E. Greenbaum

Part 1: Abstract

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Using the National Adolescent and Treatment Study (NACTS; Greenbaum et al., 1996) longitudinal database, this study explored whether adolescents with comorbidity had different service utilization rates than those with only a mental health disorder. Participants were 668 children (75% male, aged 9-17 years at the beginning of the study [M = 13.44, SD = 2.27], 72% white, 20% African American, and 8% Hispanic and other) and their caretakers. Receipt of 11 different services from the following five service areas were examined: (a) mental health (i.e., psychological testing, individual counseling, family counseling, group therapy, alcohol and drug counseling, psychotropic medication), (b) education (i.e., special education classes, speech therapy), (c) vocational rehabilitation, (d) nonroutine health care (e.g., doctor visits, emergency room), and (e) criminal justice (i.e., police contact). Logistic regression analyses indicated significantly (p < .05) higher rates of alcohol and drug counseling among the co-occurring group. However, in absolute terms, only slightly more than half (i.e., 54%) of those with co-occurrence obtained at least one alcohol or drug counseling service during the entire 6-year study period. Increased contact with law enforcement also was found among those with CO-occurrence Finally, little support was found for systems-related barriers to receiving services.

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