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The damage inflicted on our society by mental health and substance use issues is reaching epidemic proportions with few signs of abating. One new and innovative strategy for addressing these comorbid issues has been the development of outdoor behavioral healthcare (OBH). This study compared the effectiveness of three post-acute adolescent substance use situations: OBH, treatment as usual (TAU), and no structured treatment (NST). The simulated target population was 13-17 years old with comorbid substance use and mental health issues. When costs were adjusted for actual completion rates of 94% in OBH, 37% in TAU, and $0 for NST, the actual treatment costs per person were $27 426 for OBH and $31 113 for TAU. OBH also had a cost–benefit ratio of 60.4% higher than TAU, an increased Quality in Life Years (QALY) life span, societal benefits of an additional $36 100, and 424% better treatment outcomes as measured by the Youth Outcome Questionnaire (YOQ) research instrument.

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Mental health issues are a growing problem worldwide, and their detection can be complicated. Assessments such as the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) questionnaire can be useful tools for detecting depression and anxiety, however, due to being self-reported, patients may underestimate their own risk. To address this problem, two new assessments are introduced, i.e., the PHQ-V and GAD-V, that utilize open-ended video questions adapted from the PHQ-9 and GAD-7 assessments. These video-based assessments analyze language, audio, and facial features by applying recent work in machine learning, namely pre-trained transformer networks, to provide an additional source of information for detecting risk of illness. The PHQ-V and GAD-V are adept at predicting the original PHQ-9 and GAD-7 scores. Analysis of their errors shows that they can detect depression and anxiety in even cases where the self-reported assessments fail to do so. These assessments provide a valuable new set of tools to help detect risk of depression and anxiety.