This report summarizes the findings in a review of the mental health and substance abuse treatment services to youth incarcerated in facilities of the California Youth Authority (CYA), over many visits throughout 2003. The report is divided into two parts: (1) the accepted standards of service in the field with related findings and (2) the questions posed by the State Attorney General’s Office with related findings. The appropriate mental health standards of care for youth held in secure juvenile justice facilities include: (1) screening/initial assessment; (2) specialized mental health assessment; (3) treatment planning; (4) case management; (5) mental health counseling; (6) management of psychotropic medications; (7) crisis management; and (8) youth development/treatment programs. Twenty-two questions were posed by the State Attorney General’s Office and answered on the mental health and substance abuse treatment services. Highlights of the questions posed include: (1) on a system-wide level, is the mental health care provided by the CYA adequate and does it conform to community standards; (2) are the CYA’s mental health care policies and procedures adequate; (3) has the CYA implemented appropriate mental health quality assurance procedures; (4) does the CYA have a sufficient number of psychiatrists, psychologists, and other health care professionals to provide an adequate level of mental health care services; (5) on a system-wide level, does the CYA appear to have a sufficient number of ancillary personnel to appropriately care for youth; (6) does the CYA appropriately screen incoming youths for mental health treatment needs; (7) on a system-wide level does the CYA provide adequate mental health care to its general population; (8) on a system-wide level, is the CYA’s use of physical restraints appropriate; (9) on a system-wide level, does the CYA have sufficient number of beds for its mental health treatment programs; (10) does the CYA offer adequate rehabilitation programs; (11) are the CYA’s rehabilitative programs effective; (12) do the rehabilitative programs meet regularly and are youths able to attend; and (13) does the CYA have enough staff to provide an adequate level of rehabilitative programming?