This paper discusses three issues from a follow-up descriptive study of the referral of 22 black, I ' high-risk,' adolescents for psychiatric hospitalization, and their readjustmeut to the community. The first issue concerns the effects of labeling u on the adolescent's readjustment. We found differences between those labemf mentally retarded and those labeled as underachievers in their readjustment to the community. Second, several variables were identified M influencing referrals for hospitalization, subsequent readjustment, and discharge placement. The final issue deals with the effects of the therapist's dlingnesu to extend themselves to culturally different families upon parental involvement in the adolescent's therapy.
This article discusses treatment issues raised by a group of "high risk" adolescents and their problems before and after hospitalization in a psychiatric facility. The adolescents are considered high-risk because of where they live, their ethnic origin, and their reported intellectual level. All lived in South Central and Southwest Los Angeles, themselves considered high-risk areas because of frequency of crime, school dropouts, limited recreational and community facilities, and overcrowded, inadequate public schools. The youngsters are black, and thus encounter the problems our society poses for racial minorities, including the limited services available within and outside their own community. In addition, none were achieving to grade level in school and were labeled either mentally retarded or as underachievers. Each of these factors has a profound effect upon the alternatives available for an adolescent's growth and development, especially when behavior problems in their homes, schools, and communities lead to hsopitalieation. These same fac- tors may serve as barriers to effective mental health interventions aimed at breaking the cycle of failure-producing events in their lives.
The purpose of the paper is to examine the factors as related to the way the youngsters entered the psychiatric system, amount of parental involvement during treatment, and the adolescents' readjustment to the community following discharge. As the sample is homogeneous in terms of residence and ethnicity, these factors are discussed in a descriptive way, while differences in labels of intellectual functioning allow us to raise questions about the effects of such labels. Recommendations are offered to improve the treatment of black, high-risk, developmentally disabled adolescents.
THE ADOLESCENTS
The issues raised herein were generated by our work with a psychiatric inpatient unit designed to serve the mildly and moderately mentally retarded adolescent. The program included individual and group therapy, school, occupational, and