Availability of integrated care for mental health conditions in adolescent-only substance abuse treatment programs

Objectives: Adolescents receiving substance abuse treatment often have co-occurring mental health conditions, suggesting that delivering these two types of services as integrated care may be advantageous. This research describes the availability of integrated care in adolescent-only treatment programs and organizational correlates of such services. Methods: Telephone interviews were conducted with 146 managers of adolescent-only addiction programs about the availability of integrated care and organizational characteristics. Results: About 28% of programs offered integrated care for substance abuse and psychiatric problems even for persistent/serious mental illness (SMI), 36% treated both conditions except in cases of SMI, and 36% did not offer integrated care. A multinomial logistic regression model, with “no integrated care” as the reference, revealed that publicly funded adolescent programs were significantly less likely to offer full integrated care (odds ratio = .42) and integrated care except for SMI (odds ratio = .41) than privately funded adolescent programs. Additional analysis revealed that these differences were largely explained by organizational characteristics. Publicly funded programs offered significantly fewer levels of care and were less likely to employ any psychiatrists or nurses; each of these organizational characteristics was positively associated with the odds of offering integrated care. Conclusions: Adolescents receiving care in publicly funded addiction treatment programs face disadvantages in access to integrated care for co-occurring disorders. The differential availability of these services between publicly and privately funded adolescent treatment programs can be explained by differences in other organizational characteristics, such as medical staffing and the number of levels of care offered.