No single organization, however innovative or powerful, alone can address youth substance abuse in a community. A dedicated group of community members, philanthropists, behavioral health providers, law enforcement, government partners, and parents, understood this and came together to collectively take ownership of the disturbing rates of opioid abuse on Staten Island.
Formed in 2011, with generous support from The Staten Island Foundation, Tackling Youth Substance Abuse (TYSA) is a community-based coalition aimed at driving major improvements in youth substance use and youth health on Staten Island. TYSA uses collective impact as the driver to successfully align resources to address the local causes of opioid abuse. Today, more than 50 organizations are participating in the TYSA effort. Moving beyond traditional partnerships and engaging all sectors of the community to test new models of collaboration, this coalition is serving as a national model for addressing youth substance abuse efforts grounded in data, strong community engagement, stakeholder collaboration, and coordinated activity across the prevention and treatment continuum.
Why Collective Impact?
Collective impact is defined as the commitment of a group of cross-sector actors to a common agenda for solving a complex social problem through alignment and differentiation of efforts. Collective impact efforts grow out of the recognition that key stakeholders across the community have a deep, vested interest in improving outcomes, and that these outcomes depend on a complex range of challenges that can only be improved through a systematic and coordinated approach owned by the many relevant players. The five necessary conditions of collective impact are:
Common Agenda: At its inception, TYSA established a common agenda that examined a shared understanding of the issue of youth substance abuse and a shared vision of a collective solution. Shared understanding focused on prioritizing substances, identifying the root causes and local conditions (easy access to opioids, barriers to treatment, social attitudes that promote drug use), and research on effective substance abuse collaboratives. The shared vision approach used evidence-based strategies, data to refine strategies, and buy-in from critical stakeholders who can affect organizational changes.
Shared Measurement: With stakeholders at the table including behavioral health providers, NYS OASAS and the NYC Department of Health and Mental Hygiene, TYSA was able to identify and gather outcome data to use as our guiding star. Identifying outcomes and agreeing to share data also provided a level of accountability for the many stakeholders. It was evident from sharing data that there were both indirect and direct outcome measures that are tied to youth substance abuse. TYSA uses clear metrics at the youth, organization, and system-levels. Some examples of data collected and shared by partners include: prevalence rates, hospitalizations, treatment admissions, overdose rates, drug-related crime statistics and age of onset.
Continuous Communication: In any organization communication plays an instrumental role in day-to-day operations. From monthly steering committee and workgroup meetings, regular check-ins from funders, to constantly being a presence on social media and in local news outlets, TYSA maintains communication among partners, the public, and funders.
Mutually Reinforcing Activities: TYSA looks to achieve major gains, not minor improvements, support the success of partner implementers, and ultimately avoid reinventing the wheel or duplicating existing programs. A strong strategic framework that identifies and improves upon already existing evidence-based programs and innovations by expanding their success, strengthening, and broadening them. These activities work to build upon existing efforts while discouraging duplication.
Backbone Support: All too often successful collaborative efforts are not sustained due to competing priorities of members. The Staten Island Partnership for Community Wellness serves as the backbone for TYSA by providing dedicated staff to align, coordinate, and support the work of member stakeholders. Qualities of a successful backbone are the flexibility to adapt, ability to influence, and passion about the work.
Starting to See Outcomes!
Because so much of the work of collective impact is about systems change, outcome level results are not typically seen in fewer than 5 years. What we can point to are the short-term wins that contribute to community change. In response to the success of a Staten Island based pilot program where NYPD Officers were equipped with naloxone, an effective medication that counteracts the effects of an opioid overdose, all NYC Police Officers are now equipped with this life saving medication. TYSA was also the first to organize a naloxone training for community members that has since been expanded across the Island. In 2011, overdose deaths were the highest out of the five boroughs of NYC at 11 per 100, 000 residents. In 2013, Staten Island dropped to 7 per 100, 000 OD deaths. We firmly believe that this decline was a result of the increased alignment and collaboration of many of TYSA’s partners including – law enforcement, treatment providers, government agencies, and the media. While we are encouraged by this early success, we know the importance of continued vigilance and efforts until our rates are below citywide averages. The effort put forth by TYSA proves that a community aligned can move forward farther and faster.