Teens Fare Better at Substance Abuse Facilities With Comprehensive Mental Health Services

Teenagers who receive substance abuse treatment at facilities with comprehensive mental health services fare better one year later, compared with those treated at facilities with fewer such services, or none at all, a new study finds.

Researchers at the RAND Corporation studied teenagers at three types of substance abuse treatment facilities. One group of 932 teens attended a site that had a psychiatrist and/or licensed social worker or psychologist on staff, and was able to offer comprehensive psychiatric services. A second group of 1,375 teens attended a site that could treat psychiatric conditions except for severe/persistent mental illness, and a third group of 1,210 teens attended a facility that could not treat psychiatric conditions.

After one year, teens who attended facilities that could treat all psychiatric conditions had lower average levels of substance use problems and substance use frequency compared with the other two groups.

“Half of adolescent substance abuse treatment facilities offer mental health services,” notes lead researcher Rajeev Ramchand, PhD, a behavioral scientist at RAND and a professor at the Pardee RAND Graduate School. “We wanted to look at whether youth who attended facilities that offered mental health treatment fared better than those who did not, because many people think that teens with a dual diagnosis of mental health issues and substance use disorder are the norm.”

Ramchand and his colleagues were surprised to find that the availability of mental health treatment at substance abuse treatment facilities made no difference in terms of symptoms of depression or conduct disorder. They presented their findings at the recent College on Problems of Drug Dependence annual meeting.

Since 2002, the proportion of adolescent substance abuse treatment facilities that offer mental health services has not changed much, noted Ramchand. “These facilities are facing real challenges. Many use public funds, and are always in jeopardy of losing funding. At the same time, they are being asked to expand mental health services, which are expensive, as well as other services, such as HIV testing.”

This study is one of a series that is looking at how adolescent substance abuse treatment can be improved and expanded. RAND is also looking at whether specific treatments that have been found effective in research studies can work well in a community treatment setting.

A government report released earlier this year found teenagers who experienced a major depressive episode in the past year had about twice the rate of illicit drug use compared with teens who had not experienced depression—37.2 percent versus 17.8 percent.