The paper describes the therapeutic programme of the Young People's Unit, Macclesfield. Admission is based on a therapeutic contract agreed with the youngster and family. Data on the first 150 admission to the Unit are presented. The information was collected from all referring agencies and a sample of youngsters and parents after an average period of two years since discharge. Results were similar to those of other follow-up studies of discharges from adolescent units, i.e. 78 per cent of neurotic disorders, 53 per cent of mixed neurotic and conduct disorders and 47 per cent of conduct disorders showed improvement. There was a high incidence of recurrence of the most significant presenting symptom (72 per cent). Nevertheless, referrers and youngsters showed a positive attitude to the treatment experience. The possible relationship of this to the contract system is discussed. A longer period of stay was found to correlate positively with improvement in conduct disorders. There is a need for further research into what aspects of a treatment milieu produce significant and lasting changes in conduct disorders.

Hurricanes and other extreme precipitation events can have devastating effects on population and infrastructure that can create problems for emergency responses and evacuation. Projected climate change and associated global warming may lead to an increase in extreme weather events that results in greater inundation from storm surges or massive precipitation. For example, record flooding during Hurricane Katrina or, more recently, during Hurricane Harvey in 2017, led to many people being cut off from aid and unable to evacuate. This study focuses on the impact of severe weather under climate change for areas of Harris County, TX that are susceptible to flooding either by storm surge or extreme rainfall and evaluates the transit demand and availability in those areas. Future risk of flooding in Harris County was assessed by GIS mapping of the 100-year and 500-year FEMA floodplains and most extreme category 5 storm tide and global sea level rise. The flood maps have been overlaid with population demographics and transit accessibility to determine vulnerable populations in need of transit during a disaster. It was calculated that 70% of densely populated census block groups are located within the floodplains, including a disproportional amount of low-income block groups. The results also show a lack of transit availability in many areas susceptible to extreme storm surge exaggerated with sea level rise. Further study of these areas to improve transit infrastructure and evacuation strategies will improve the outcomes of extreme weather events in the future.

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An earlier paper described how the problem behaviours of adolescents who had experienced treatment at the Young People's Unit, Macclesfield changed. This paper describes the components of that experience, the clients' and referrers' evaluation of those components and their attitudes to the treatment received. The study occurred after an average post‐discharge period of two years. A factor analysis produced two main clusters of attitudes relating to “personal growth” and “valuing of the unit experience”. Youngsters with positive attitudes towards the experience had significantly better outcomes. This finding is compared with a study of approved school boys. It is suggested that the components of the Young Peoples' Unit may be more suited to the maturational tasks of adolescence. The findings refute the justification that residential units have helped personal growth despite the continuation of problem behaviour. The study has implications for Health Service planning for disturbed adolescents and for community agencies' attitudes to the use of residential treatment.

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