• Evidence shows that safety-net health services for adolescents are

    • accessible to many adolescents who are uninsured or do not find private office-based services acceptable for their needs.

    • frequently more acceptable to adolescents who are uncomfortable with private office-based primary care providers, especially when they can establish relationships with providers who are sensitive to their needs and promote open communication.

    • sometimes able to offer a more appropriate mix of skills and counseling services that address risky behaviors.

    • able to provide effective disease prevention and health promotion services while also addressing issues related to risky behavior. However, such centers often can become unstable during times of fiscal uncertainty and may experience frequent personnel transitions. They also face unique challenges associated with financing of prevention and health promotion services that cannot be reimbursed.

    • important mechanisms for resolving the disparities and inequities that exist within private office-based primary care.

Specialty Care Services

  • Evidence shows that specialty care services for the adolescent population are not accessible to most adolescents. Existing specialty services in the areas of mental health, sexual and reproductive health, oral health, and substance use treatment and prevention are generally insufficient to meet the needs of many adolescents. While evidence-based therapies are available in a number of these areas, they are not integrated into many practice settings.

  • Even when specialty services are accessible, many adolescents do not find them acceptable because of concerns about disclosure of treatment in sensitive areas (such as substance use or sexual health).

  • Many specialty providers lack appropriate training to address the needs of adolescent patients, and certification programs for treating adolescents are frequently unavailable in many specialty areas.

  • The lack of appropriate specialty services that are suitable for adolescents means that effective treatment is often delayed, care is of limited duration, and services are poorly reimbursed.

  • Limitations in the quality of or access to specialty services are especially prevalent among at-risk adolescents in whom problems

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