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This chapter offers a prospective and naturalistic study of the impact of a risk-assessment and risk-management program on mentally abnormal young offenders admitted to a medium secure adolescent psychiatric inpatient unit in the United Kingdom (U.K.) because of violent, dangerous or self-harming behaviour. As a result of the risk assessment, there was a reduction in their violent, dangerous or self-harming behaviour that was significantly associated with a reduction in the number of risk factors. About 80% were discharged directly back into the community.

Although substance misuse by adolescents is widespread, few previous studies have investigated illicit drug use in adolescent psychiatric populations. The literature on adolescent substance misuse has focused on risk factors, and protective factors have received little or no attention. The study examined substance misuse and its correlates among young people referred to a regional adolescent psychiatric service. Co‐morbidity of substance misuse and psychiatric disorder was discussed, and the possible role of substance misuse as a gateway to adolescent offending examined. Recommendations for the development of adolescent substance misuse services are made.