Chestnut Health Systems will enhance and expand its adolescent outpatient substance use screening, assessment, early intervention, treatment, and recovery support services in school-based settings. The population of focus is students and their families from five high schools in Jefferson County, Missouri. Recent estimates indicate that only 6% of adolescents with a substance use disorder (SUD) received treatment during a time when the county saw an alarming increase in suicide. Since the vast majority of adolescents are enrolled in school, this is a practical setting to identify and assist them. In fact, research shows that bringing these services to youth in schools may reduce gender/ethnic disparities often found in specialty community clinics. We anticipate that participants in this project will be 14-18 years old and have SUD, with a higher than normally expected number presenting with mental health problems driven by the exceptionally high rate of positive COVID-19 cases in the county. Students referred to the program will be screened, and assessed as indicated. Students enrolled in the program will receive evidence-based SUD treatment and recovery support services and, when indicated, trauma and tobacco cessation treatment. The primary goals of this project include: 1) Increasing the number of youth/families served with evidence-based practices; 2) Improving recovery outcomes from the use of alcohol, tobacco, and other drugs; 3) Improving mental health; and 4) Increasing access to health services for underserved families. These goals will be achieved by implementing the project’s measurable objectives: provide evidence-based screening and assessment; provide evidence-based, trauma-informed, and family focused early intervention, outpatient treatment, and recovery support services for substance use to 50 adolescents and their families in year 1 and 100 adolescents and their families each year in years 2 through 5; provide evidence-based tobacco prevention/cessation services; provide education and messaging on making healthy choices to students; decrease participant rates of substance use between baseline and six-month follow-up by at least 50%; reduce participant stress between baseline and six-month follow-up for at least 50% of participants; reduce participant emotional problems between baseline and six-month follow-up for at least 50% of participants; improve participant life satisfaction between baseline and six-month follow-up for at least 50% of participants; initiate connection to mental health programs for 100% of adolescents and families identified as in need; and initiate connection to medical centers for 100% of adolescents and families identified as in need.