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Because of the many problems that impact the daily lives of at-risk girls, national, State, and local policymakers should ensure that services are available to effectively address their changing needs. The problems normally associated with adolescence are exacerbated for girls in crisis. As the above data illustrate, girls present numerous issues including physical and sexual abuse by adults; conflicts at home and school; emotional problems; substance abuse; suicide attempts; problems associated with early sexual initiation, such as teen pregnancy, AIDS, and other sexually transmitted diseases; gang involvement; and low self-esteem. It is imperative that services be available to address these issues. The list below summarizes a sampling of societal problems confronting at-risk girls that warrant special attention by service providers:
 Violence. The death of a parent, uncle, brother, grandparent, neighbor, or close friend is not uncommon among at-risk girls. Helping these girls cope with death and loss (especially loss due to violence) requires specialized skills in grief counseling.
Sexual and physical abuse. Many at-risk girls have experienced abuse. In a Commonwealth Fund Survey, 21 percent of the high school girls surveyed reported past physical or sexual abuse. The majority of the abuse occurred at home (53 percent) and more than once (65 percent). Twenty-nine percent of those abused did not tell anyone and 46 percent had depressive symptoms, more than twice the rate of girls who reported no abuse (18 percent). Abused girls also are at double the risk for signs of eating disorders (The Commonwealth Fund, 1997).
Domestic violence. Females are at least three times more likely than males to be victims of family violence (Bureau of Justice Statistics, 1993).
High-risk sexual behaviors. Because at-risk girls have not had appropriate role models and the opportunity to learn the difference between love and sex, they often equate sexual relationships with love and caring. As a result, they make dangerous choices to engage in high-risk sexual behaviors that can lead to pregnancy, HIV, and sexually transmitted diseases.
Incarceration of close family members. Girls in need are often the daughters of parents who are incarcerated. Separation from nurturing adults creates a long-term sense of isolation and fear.
Gang involvement. A significant number of girls are becoming involved in gangs. Factors that motivate girls to join include abuse inflicted by parents and other relatives, poverty, and the failure of schools and other institutions to recognize risk factors early (Molidor, 1996). Gang membership threatens the girls and the agency staff who are seeking to provide help. Working with young women who are torn between fear of and loyalty to gangs and a desire to leave presents special challenges to staff and the community.
Alcohol, tobacco, and other drugs. Girls are closing the gender gap with their male counterparts in the use of substances. The motivation for using these substances is clearly linked to gender-specific issues (e.g., body image, desire to escape the emotional pain of abuse, and peer pressure).
Adolescent girls and health. Girls have unique health issues that warrant special attention and access to services. Girls often do not report medical concerns because of fear, lack of trust, and embarrassment.
Despite these trends and the alarming patterns of self-destructive behaviors that girls are exhibiting, little attention has been focused on the unique needs of girls, the obstacles they face, or the services they require. Programs designed to benefit women and girls are significantly underfunded. Currently, less than 5 percent of the philanthropic dollars in the United States are specifically designated for helping women (Nokomis Foundation, 1998; Valentine Foundation and Women's Way, 1990). Experienced service providers report that girls wait longer for services than boys, and local communities often lack gender-specific programming for girls in need. Girls are more likely than boys to be held in detention for status offenses such as running away from home, truancy, or other noncriminal offenses (Chesney-Lind and Shelden, 1997).
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