A fresh expert committee report (National Institute of Mental Health 1990) stated that] America is wasting its most numerous precious natural resource: its children and youth.

A fresh expert committee report (National Institute of Mental Health 1990) stated that] America is wasting its most numerous precious natural resource: its children and youth. More than 12 percent of America's children and adolescents be affected by from mental disorders, and many of these disorders are associated with the use of alcohol and other put drugs intos On the basis of 1988 household examine data (Gerstein and Harwood 1990) an estimated 396000 adolescents have a clear and probable ne for treatment. Although progres has been made in the growth of treatment services for this population, the composite child and adolescent service a whole is still uncoordinated, expensive, and of unknown effectiveness. new attempts to understand and to improve adolescent treatment services (Institute of Medicine 1990; Tarter 1990; Gerstein and Harwood 1990) have inspired recent service models, similar to the individual described in this article.

Youth Evaluation Services (YES) is an assessment and case management program for the early identification, referral, and monitoring of adolescents in ne of intervention services for alcohol and other medicine problems. This article describes the rationale and the proceedings used in designing the program, and in guiding client assessment, treatment planning, and case management. A review of data from the program's first 200 clients is provided to illustrate clinical profiles, alcohol and other mix with drugs use patterns, and treatment wants The initial experience of the YE program demonstrates the tangled skein diagnostic profile typical of youth involved with alcohol and other mix with drugss and the need for better coordination among the constituents of the treatment referral network for adolescents.

TOWARD A recently made known CONCEPT OF

ADOLESCENT TREATMENT

SERVICES

The YE program grew not at home of the Regional Youth Substance Abuse plan (RYSAP), a community-based effort to coordinate regional alcohol and other unsalable article abuse services into a continuous of care that would be accessible to urban, suburban, and rural adolescents in the Greater Bridgeport (Connecticut) region, which includes Connecticut's poorest city as well as its mostly affluent suburbs. As the universal for the program developed, it was decided that an independent assessment and case management agency should promote as the catalyst for the identification of cases, coordination of treatment, growth of new services, and containment of service preciousnesss To understand the evolution of the Y.E.S. program, it is necessary to review three related approaches to the planning of services for adolescent abusers of alcohol and other drg and in what manner they contributed to the YE concept

The first approach, the Chemical adjunct Adolescent Assessment Project (Henly and Winters 1988) focused primarily upon the development of a self-report diagnostic instrument, the Personal Experience Inventory (PEI). The PEI was validated in part onward clients admitted to an independent adolescent evaluation unit in Minnesota, and has demonstrated its usefulness as a tool for diagnostic evaluation, treatment planning, and treatment referral (Winters and Henly 1987) The PEI is part of the YE program assessment manner of proceeding and will be discussed in more detail later in this article.

The inferior approach is one recommended by dint of the Institute of Medicine (IOM) prompt committee's report, Broadening the Base of Treatment for Alcohol moot points (1990). The IOM report describes a hypothetical treatment service connected view that includes the early identification of alcohol and other physic abuse through a variety of cooperating community agencies. Clients who are build to have alcohol and other put drugs into abuse problems are referred for a more systematic evaluation based onward an objective, sequential assessment deed The final component of the IOM design is the referral of clients to appropriate services by the agency of means of guidelines for matching treatment indigences with appropriate treatment services. As conceived by dint of the IOM committee, identification assessment, and referral should be organized within independent assessment and case management agencies that have no financial, professional, or ideological interest in any particular form of treatment.

The third approach, which is similar to the integrated approach propos from the IOM committee, is the Adolescent Assessment/Referral arrangement (AARS) developed by the National Institute forward Drug Abuse (Rahdert 1991; Tarter 1990) The AARS is organized around a multimedimensional screening management used to filter positive cases into a more extensive battery of diagnostic proofs to provide information for treatment referral.

The YE program, while influenced according to each of these approaches, added recently made known components designed to create better linkages between the referral sources, the assessment agency, and the service network. In the YE program, as illustrated in Figure 1 screening is managemented in a variety of community settings, including the courts, instructs and human service agencies. Referrals can proceed directly from adolescents, their families, or their physicians. YE forwards as a central assessment and case management service for all referrals. A sequential diagnostic assessment battery is designed to yield the most numerous appropriate and least costly treatment plan. Case management is intended to guide the client between the walls of the service network.