The Senate Select Committee on Indian Affairs is considering legislation to improve mental health services to American Indians and Alaska Natives. This report is in response to the Committee's request for information on the mental health needs of Indian adolescents and the services available to them. The section on mental health problems among American Indian and Alaska Native youth examines: (1) diagnosable mental disorders, particularly developmental disorders, depression, suicide, anxiety, and substance abuse and dependence; (2) serious, but less diagnostically specifiable, problems of adolescence, such as low self-esteem, conduct disorder, school dropout, delinquency, and running away; and (3) environmental risk factors, including otitis media, fetal alcohol syndrome, child abuse and neglect, parent alcoholism, family disruption, and stressful school environment. The section on delivery of mental health services discusses: (1) agencies and programs involved in service delivery, including the Indian Health Service (IHS), Bureau of Indian Affairs, tribal health programs, urban Indian health programs, and state and local service agencies; (2) treatment settings and therapeutic interventions adapted to and by American Indians; (3) cultural insensitivity in Indian mental health programs; (4) community involvement; and (5) agency coordination efforts. The report concludes that 160-200 child and adolescent mental health providers are needed in IHS service areas, and presents Congressional policy options. This report contains 390 references and 37 data tables. The appendixes include a review of earlier evaluations of Indian adolescents' mental health needs. (SV)