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4 TFAH • WBT • PaininTheNation.org Partnerships A thorough and comprehensive approach to addressing how the education sector can help tackle the alcohol, drug and suicide crisis requires a careful systems approach. Simply creating new programs in schools without integrating them with and connecting them to other systems (i.e., the healthcare sector, the social safety net and others) will not bring about as robust a change as possible. Additionally, in some cases, adding a program without a systems plan could actually further fragmentation, resulting in additional layers of complexity in an already overly complex system. Incorporating this systems lens requires a comprehensive plan that brings together all community capabilities and resources. A community thrives when all resources are marshaled to build protective factors at the individual student and family levels, which, in turn, will help identify at-risk students and ensure they receive the support and services they need. For example, models for effective cross-sector coordination include the Communities That Care program (CTC), PROmoting School/community-university Partnerships to Enhance Resilience (PROSPER) and the federally-supported Drug Free Communities (DFC) program. CTC is a community-based approach that targets predictors of problems, rather than waiting for problems to occur. Communities that implemented CTC had fewer health and behavior problems among their students and students were more likely to have abstained from alcohol and drug use, even after the program ended. 22 A cost-benefit analysis found a benefit of $8.22 for every dollar invested in a CTC system. 23 PROSPER is an evidence-based state delivery system for supporting sustained, community-based implementation of scientifically-proven programs that reduce adolescent substance misuse. Youth participants scored significantly lower on a number of negative behavioral outcomes, including drunkenness, cigarette use, marijuana use, use of other illicit substances, and conduct problem behaviors, up to 6.5 years past baseline. And, in many cases, higher- risk youth benefited more. 24 DFC is a federal program designed to encourage community stakeholders (schools, businesses, media, parents, etc.) to work together to deal with substance misuse problems in a comprehensive and coordinated manner. 25 A recent evaluation of DFC found that, among middle school youth across all DFC coalitions ever funded, prevalence of alcohol use declined by 27 percent, prevalence of tobacco use declined by 32 percent, prevalence of marijuana use declined by 14 percent, and prevalence of (illicit) prescription drug use declined by 11 percent. And, among high school students, use of alcohol declined by 19 percent, of tobacco by 28 percent, of marijuana by 6 percent, and of (illicit) prescription drug use by 16 percent. ROI for every dollar invested in a CTC system $8.22

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