to ongoing change (U.S. Congress and Office of Technology Assessment, 1991). Nevertheless, the overall trend, with the exception of abortion, has been to protect the confidentiality of adolescents’ health information when they are legally allowed to consent to their own care. When exceptions are made, such as to grant health professionals discretion to disclose information to parents even when the minor has consented to the care and objects to disclosure, they are usually grounded in the importance of protecting the health of adolescents or others.


  • Evidence shows that health services that are confidential increase the acceptability of services and the willingness of adolescents to seek them, especially for issues related to sexual behavior, reproductive health, mental health, and substance use.

  • Existing state and federal policies generally protect the confidentiality of adolescents’ health information when they are legally allowed to consent to their own care.


This chapter has presented a review of current health services for adolescents and the settings where those services are typically received, with a focus on both the array of mainstream and safety-net primary care services and specialty services. It has also proposed the five objectives of accessibility, acceptability, appropriateness, effectiveness, and equity as a valuable framework for assessing health services and health care models that serve adolescents. Available evidence shows that health services for all adolescents, including those who are particularly vulnerable because of their demographic characteristics or other circumstances, do not reliably and consistently meet these objectives. Evidence also shows the lack of a system that provides coordinated health promotion, disease prevention, and behavioral health services for adolescents—all important elements for appropriately and effectively addressing the adolescent health needs discussed in Chapter 2.


Aarons, G., Brown, S., Hough, G., Garland, A., and Wood, P. (2001). Prevalence of adolescent substance use disorders across five sectors of care. Journal of American Academy of Child and Adolescent Psychiatry, 40, 419–426.

Adebimpe, V. R. (1981). Overview: White norms and psychiatric diagnosis of black patients. American Journal of Psychiatry, 138, 279–285.

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