The Board used various data sources to develop a picture of adolescent substance abuse and its impact on the community. There are approximately 118,000 adolescents (age 10 -19) in the county. The ADAS Board learned that 30% of Hamilton County teens use alcohol on a regular basis, 22% use tobacco, and 16% use marijuana. Emergency room data revealed that 26% of adolescents seen for psychiatric problems also had an alcohol or other drug problem.

The ADAS Board sent an 18-item questionnaire to 120 service providers, with a 51% response rate. Key findings revealed that the largest gaps in services for adolescents are in treating those with both substance use and mental health disorders (or dual disorders) and in providing residential treatment for those who need it. Substance abuse treatment providers reported that approximately 33% of the current adolescent caseload were not admitted to treatment or did not complete treatment or continuing care because of lack of parental support or the severity of dual disorders. This information led the ADAS Board and its advisory committee to decide that an adolescent treatment motivation project would best fit the county's needs at this time.

The ADAS Board developed a county-wide plan for adolescent services (see "Adolescent Treatment Enhancement Program" for more information).

The ADAS Board developed the infrastructure and partnerships necessary for collaboration on adolescent treatment services and support from a variety of stakeholders.

The ADAS Board convened an adolescent services advisory committee that consisted of 25 executives, clinicians, and administrative staff from 22 different agencies and institutions in the county. This committee met twice a month for eight months to identify gaps in services and develop the plan for improved treatment services. The committee brought together individuals who had not previously worked together. The committee members reported at the end of the project that the networking opportunity provided by this project will strengthen the entire child-serving system. The process resulted in a collaborative project rather than one that required agencies to compete with each other for limited service dollars.

The ADAS Board also provided a three-day workshop for county service providers on Life Skills Crisis Intervention (LSCI), a therapeutic strategy for using crisis situations as opportunities to help youth learn behavioral alternatives. This model was chosen because of the need voiced in the advisory committee for a strength-based model to use with the hard-to-serve youth targeted during the planning process. Thirty-four clinicians and administrators attended the training with very positive post-event evaluations.

The facilitators of the planning process included:

• the broad variety of adolescent-serving entities and the variety of organizational levels included in the advisory committee;
  
• the LSCI training in the middle of the planning process;
  
• the commitment of the ADAS Board to an open process, which allowed for collaboration and "outside the box" thinking; and
  
• the process being collaborative rather than competitive.
  

The ADAS Board recognized only one barrier to the planning process: the failure of some organizations to provide consistent attendance to the advisory committee.

The Foundation used the needs assessment from this project as data for the white paper: Substance Abuse Treatment Needs of Adolescents in Southwest Ohio.