Thus, most mental-health care for adolescents and
young adults is typically delivered in community and
outpatient settings, often within the context of adult
services. In developed countries, encouraging
development of child and adolescent mental-health
services has taken place. However, such services have
emerged only fairly recently from an exclusive focus on
younger children, and typically still struggle to manage
young people in the middle and later stages of
adolescence, when adult patterns of disorders generally
emerge, whereas adult services are mainly focused on
older and more chronic patients, and exclude and neglect
younger patients. Iatrogenic eff ects can take place when
adolescents and young adults are mixed with older
chronically ill patients, including increased risks of
suicide.127 Initial access and continuing participation of
young people in adult mental-health service