Commentary: Quality of alcohol, drug, and mental health services for American Indian children and adolescents

American Indian children and adolescents suffer from a high prevalence of a lcohol, drug, and mental (ADM) dis orders. Unfortunately, the systems of se rvices for these children and youth have never been able to address adequat ely their mental health needs, Thus, the revolutionary changes now taking p lace within these service systems, in particular the marked increase in the direct pro vision of services by Indian tribes and organizations, provides a unique opportunity to address these historical shortcomings, In this pap er, we describe our existing knowledge concerning the quality of ADM servic es for American Indian children and adolescents and their critical sociodem ographic, sociocultural, and epidemiologic contexts. We then consider the i mplications of these studies for improving the quality of care as well as i ts measurement and monitoring.