|October 24, 2003|
Facilities Primarily Serving Adolescents: 2002
The National Survey of Substance Abuse Treatment Services (N-SSATS) is an annual survey of all facilities in the United States, both public and private, that provide substance abuse treatment. This issue of The DASIS Report provides data on the substance abuse treatment facilities that primarily served adolescents. In 2002, the N-SSATS survey collected data from 13,843 facilities, of which 897 (7 percent) served primarily clients younger than 18 years old (75 percent or more of their clients). For this report, these are characterized as "adolescent" facilities. The 897 adolescent facilities had 31,800 clients younger than age 18 in treatment on the survey response date, March 29, 2002. This was 34 percent of all clients younger than 18. The two-thirds (65 percent) of facilities with no clients younger than 18 years old are categorized as "adult" facilities. The remaining 28 percent of facilities, which served both adults and adolescents, are referred to as "mixed" facilities.
Three-quarters (75 percent) of adolescent facilities were operated by private non-profit organizations, whereas 61 percent of adult facilities and 57 percent of mixed facilities were operated by private non-profit organizations (Table 1). The proportion of adolescent facilities operated by private for-profit organizations (15 percent) was less than the proportion of adult (25 percent) or of mixed facilities (27 percent).
Sixty-one percent of adolescent facilities primarily focused on substance abuse treatment. A larger percentage of adult facilities (64 percent) had this as their primary focus, while a smaller percentage of mixed facilities (52 percent) primarily focused on substance abuse treatment. One-quarter (25 percent) of adolescent facilities primarily focused on a mix of mental health and substance abuse treatment compared with 21 percent of adult facilities and 35 percent of mixed facilities.
Problems for Which Clients Were Treated
In adolescent facilities, 73 percent of clients were treated for both alcohol and drug abuse problems, whereas about 55 percent each of clients in adult and in mixed facilities were treated for both problems (Figure 1). Only 8 percent of clients in adolescent facilities were treated for alcohol abuse alone, less than the proportion in adult facilities (22 percent) and in mixed facilities (28 percent). Clients in adolescent facilities and in mixed facilities were equally likely to be treated for drug abuse alone (about 18 percent), while clients in adult facilities were more likely to be treated for drug abuse alone (24 percent).
Type of Care
Most adolescent facilities (68 percent) reported providing outpatient care, although this type of care was more frequently provided by adult facilities (76 percent) and mixed facilities (96 percent) (Figure 2). A higher proportion of adolescent facilities (44 percent) offered non-hospital residential care than did adult facilities (33 percent) or mixed facilities (11 percent).
Services and Special Programs
The services offered most frequently at adolescent facilities included individual therapy (97 percent), group therapy (94 percent), substance abuse assessment (90 percent), discharge planning (86 percent), and drug/alcohol urine screening (80 percent). These proportions differed little from those offered by adult and mixed facilities. In addition to services, facilities offered special programs or groups for particular populations. Ninety-one percent of all adolescent clients were in facilities with a special program for adolescents. This included the third of all adolescent clients (34 percent) in adolescent facilities (which, by definition, offered special programs for adolescents), and the 57 percent of all adolescent clients in mixed facilities that offered a special program for adolescents. In addition, adolescent facilities were more likely than adult facilities to offer special programs for clients with co-occurring substance abuse and psychological problems (57 vs. 46 percent).
Payment and Managed Care
Most adolescent facilities (77 percent) accepted cash or self-payment, although this type of payment was more frequently accepted by adult facilities (89 percent) and mixed facilities (95 percent) (Figure 3). A majority of adolescent facilities also accepted private health insurance (62 percent) and Medicaid (58 percent).
Nearly half of adolescent facilities and of adult facilities had agreements or contracts with managed care organizations (48 and 46 percent, respectively). Two-thirds (65 percent) of mixed facilities had such contracts.
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