Assessing and treating co-occurring disorders in adolescents: examining typical practice of community-based mental health and substance use treatment providers.

Co-occurring mental health and substance use disorders in adolescents are common. However, limited efforts have been directed at understanding how treatment providers in community settings deal with this frequent challenge. In this study, treatment providers from both substance use and mental health settings were interviewed to examine their common practices regarding the assessment and treatment of co-occurring depression and substance use disorders in adolescence. About 93% of treatment providers reported treating adolescents with these co-occurring conditions. However, few providers reported using formal assessment practices (23-30%) or treatment protocols for co-occurrence (10%). Providers in mental health settings (particularly psychologists) were more likely than those in substance use settings to formally assess for depression [Chi2(1, N = 30) = 3.62, P = .065] but less likely to do so for substance use [Chi2(1, N = 30) = 9.46, P = .004]. Findings are considered with regard to implications for assessment and treatment outcomes in this high-risk population.