Dedication of some time to care coordination or case management is critical for young people with complex needs (Schuetz & Berry, 2009). Adolescents generally lack adequate knowledge of what assistance is available or how to find what they need. For clients referred to AOD services from statutory authorities, supervision and support is generally necessary to help young people understand expectations and meet their obligations. Feelings of alienation from society and resentment towards authority may also preclude these youth from actively seeking and receiving treatment for AOD and mental health issues (Meade & Slesnick, 2002). Both voluntary and involuntary clients may also need persistent encouragement and personal support to increase insight into their needs, and their ability to benefit from services they receive.
In addition to strategies targeting access, engagement and coordination, it is increasingly recognised that some services that provide a variety of different therapeutic interventions are important to the overall capacity of service systems to provide holistic multidimensional care for clients with complex needs. The widespread use of narrow problem definitions to determine eligibility for services constitutes a pervasive barrier to service access for clients with multiple and complex needs (Ungar, 2005a). Providing a variety of services at single locations like drop-in centres or primary health care services has been repeatedly identified as an effective service model for transient and homeless youth with AOD and mental health problems (Barry et al., 2002; Busen & Engebretson, 2008; Slesnick et al., 2007; Statham, 2004).
The building of these relationships often depends heavily upon the interests, skills and leadership of particular individuals. This success factor has a downside in terms of sustainability. Again this points us to the question of advocacy and other strategic work at the management level. In addition to schools and the education system mentioned previously, this may also apply to our relationship with housing and homelessness support services.