The studies we reviewed suggest that youths treated in hospital-based settings who have a history of severely aggressive-destructive behavior and whose parents abuse substances are more likely than their peers who were treated but do not have these histories to be recommended for out-of-home placement on discharge. From both a mental health and a social perspective, severely aggressive behavior in children and substance abuse in parents require focused attention in hospital-based treatment of children and adolescents. Intervention is crucial not only because of the human suffering involved but also because of the enormous cost of out-of-home placements for youths and for adults who manifest these and associated problems, such as antisocial behavior and criminality.
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