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Schools are a critical, but underutilized setting, for adolescent substance use prevention and intervention. While Multi\u2010Tiered Systems of Support (MTSS) provide a useful framework, meaningful engagement of youth, families, schools, and communities is crucial for effective and equitable systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Contributions to Theory<\/jats:title>\n                    <jats:p>This paper asserts that youth\u2010family\u2010school\u2010community partnerships should serve as the core foundation of effective school\u2010based substance use programming. Drawing on Ecological System Theory and bridging school mental health and substance use literature, this paper proposes a framework that centers partnership, equity, and engagement within MTSS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for School Health Policy, Practice and Equity<\/jats:title>\n                    <jats:p>School policy should prioritize funding and infrastructure that promotes genuine youth, family, school, and community collaboration, including telehealth options, flexible scheduling, and hiring school\u2010based mental health staff. These efforts can help to improve equitable access to multi\u2010tiered school substance use services for youth and families.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Partnerships among youth, families, schools, and communities should be central to school\u2010based substance use programming to support the development of effective and equitable school mental health systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/josh.70248","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:31:25Z","timestamp":1790692285000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Strengthening Partnerships in School\u2010Based Substance Use Prevention and Intervention for Adolescents"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5188-4414","authenticated-orcid":false,"given":"Julianna","family":"Casella","sequence":"first","affiliation":[{"name":"National Center for School Mental Health, Department of Psychiatry University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1218-4532","authenticated-orcid":false,"given":"Aijah K. B.","family":"Goodwin","sequence":"additional","affiliation":[{"name":"National Center for School Mental Health, Department of Psychiatry University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5921-2601","authenticated-orcid":false,"given":"Nancy","family":"Lever","sequence":"additional","affiliation":[{"name":"National Center for School Mental Health, Department of Psychiatry University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4473-9360","authenticated-orcid":false,"given":"Cindy M.","family":"Schaeffer","sequence":"additional","affiliation":[{"name":"National Center for School Mental Health, Department of Psychiatry University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Key Substance Use and Mental Health Indicators in the United States: Results From the 2023 National Survey on Drug Use and Health","author":"Substance Abuse and Mental Health Services Administration","year":"2024"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.su7304a1"},{"key":"e_1_2_10_4_1","volume-title":"Monitoring the Future National Survey Results on Drug Use, 1975\u20132024: Overview and Detailed Results for Secondary School Students","author":"Miech R. 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