Adolescents' and providers' perspectives on the need for and use of mental health services.

PURPOSE This study examines need for and use of services from both the adolescent's and the service provider's viewpoints. METHODS The Youth Services Project interviewed 792 youths from the juvenile justice, education, primary health care, and child welfare sectors (200 each); gathered anonymous tallies of the mental health of youthful clients at each sector; and conducted focus groups with providers. RESULTS A high percentage of youths (12-15%) met DSM-IV criteria for a mental health disorder, yet the sector clients were not identified as having mental health problems. Juvenile justice and child welfare sectors identified the highest percentage of adolescent clients as having mental health problems, and provided the most services (50-80%). The primary health care sector recorded no mental health disorders among the tallied clients, and provided the fewest mental health services (< 20%). Providers' complaints that they lacked knowledge concerning mental health assessment and lacked referral or treatment resources closely paralleled the degree to which their sector underserviced youths. CONCLUSION Lack of knowledge about the extent of need in adolescents, methods for assessing or treating, and referral resources handicap service providers and explain the gap between need and service.