Commentary: quality of alcohol, drug, and mental health services for American Indian children and adolescents.
American Indian children and adolescents suffer from a high prevalence of alcohol, drug, and mental (ADM) disorders. Unfortunately, the systems of services for these children and youth have never been able to address adequately their mental health needs. Thus, the revolutionary changes now taking place within these service systems, in particular the marked increase in the direct provision of services by Indian tribes and organizations, provides a unique opportunity to address these historical shortcomings. In this paper, we describe our existing knowledge concerning the quality of ADM services for American Indian children and adolescents and their critical sociodemographic, sociocultural, and epidemiologic contexts. We then consider the implications of these studies for improving the quality of care as well as its measurement and monitoring.
Novins
D K
DK
Faculty of the National Center for American Indian and Alaska Native Mental Health Research, University of Colorado Health Sciences Center, Denver 80210, USA.douglas.novins@uchsc.edu
Fleming
C M
CM
Beals
J
J
Manson
S M
SM
D000293:Adolescent; D002648:Child; D003710:Demography; D017831:Diagnosis, Dual (Psychiatry); D006297:Health Services Accessibility; D006303:Health Services, Indigenous / Q000592:standards; D006801:Humans; D007198:Indians, North American / Q000523:psychology; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy; D008605:Mental Health Services / Q000458:organization & administration / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care; D015995:Prevalence; D011787:Quality of Health Care; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000628:therapy; D014481:United States / Q000453:epidemiology; D016549:United States Indian Health Service / Q000458:organization & administration* / Q000592:standards