this patchwork of care. Under its statutory mandate, the Substance Abuse and Mental Health Services Administration (SAMHSA) must provide national data on mental health and substance abuse treatment services and on persons with mental and substance use disorders. This mandate includes the determination of the national incidence and prevalence of the various forms of mental disorder and substance abuse, as well as characteristics of treatment programs.

SAMHSA has focused much of its efforts on specialty providers and services supported through state substance abuse and mental health agencies. However, nontraditional settings, such as jails, prisons, schools, and general hospitals, are becoming increasingly important as sites of care for youth with MEB disorders. Exclusion of other settings in which young people often receive care provides a misleading and incomplete picture of service use.

Recommendation 2-2: The Substance Abuse and Mental Health Services Administration should expand its current data collection to include measures of service use across multiple agencies that work with vulnerable populations of young people.

The Centers for Medicare and Medicaid Services (CMS) and programs funded by CMS collect information on use of Medicaid-funded services for prevention and treatment. These data could provide a rich set of information on trends in utilization of services across various health care providers. Analysis of these data in conjunction with the above prevalence and service use data, with appropriate privacy protections, could provide additional insights.

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