Expanding an Integrated Model for Substance Use and Mental Health Treatment for Youths

For more than 30 years, the Comprehensive Adolescent Rehabilitation and Education Service (CARES), which is affiliated with Mount Sinai Morningside, has been providing educational and psychiatric support to high school students throughout New York City. Starting in January 2026, it will be expanding its reach through a new partnership with the Youth Shelter Program of Westchester (YSOW).

The expansion, which has been made possible by a grant received by YSOW, is a major undertaking for the CARES team, and one that director Shilpa R. Taufique, PhD, is enthusiastic about. Not only does it provide access to integrated, multidimensional care to more youths who have often fallen through the cracks, it also serves as a test for adapting and delivering the CARES model in a new community-based environment beyond traditional educational settings.

“What empowers this initiative is our shared belief that healing and growth happen when we treat the whole person within their community,” says Dr. Taufique, Chief Psychologist of the Division of Psychology.

“By aligning CARES’s evidence-based behavioral health model with YSOW’s decades of justice-centered experience, we’re creating a coordinated, youth-centered network that promotes resilience, opportunity, and hope across diverse systems of care,” she says.

A Unique Integrated Approach

Many programs in the United States take a siloed approach to youth mental health and substance use treatment, addressing them as separate conditions, according to Dr. Taufique, who is also Associate Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai.

CARES was founded in 1990 as a partnership among the New York City Department of Education and entities that today are part of the Mount Sinai Department of Psychiatry and the Addiction Institute of Mount Sinai. The program’s multidimensional approach addresses the impact of mental health and substance use on brain development, academic performance, and lives. This integrated approach—that evolved over time—makes CARES unique among similar initiatives nationwide, says Dr. Taufique.

“Through our integrated approach, we help youth become what they want to be by addressing the challenges they are facing while earning their education,” she says.

Youth are engaged in CARES through one of two tracks. Those who are most in need of structure and skills building are enrolled in CARES Academy, a therapeutic school for public high school students who are from the city’s five boroughs and who have graduated eighth grade. The goal is to help students achieve stability through multidisciplinary daily therapy—a mix of individual, group, milieu, and family sessions—and pharmacological treatment so they can return to regular school or outpatient treatment in a year.

The service’s intensive approach has proven successful, with 80 percent of CARES Academy students demonstrating improvement in academic performance, 86 percent achieving a reduction in their symptoms, and 75 percent transitioning to lower levels of care after completing the program. Those students who do require further care upon completion have short-term access to therapeutic services, clinicians, and peers through the service’s AfterCARES program.

Community response to CARES, coupled with societal demand for increased access to mental health services, led to the launch of a second track, Use Prevention Recovery Intervention Services and Education (UPRISE), in 2019. This unique initiative draws on the CARES Academy model to deliver customized, embedded clinical programs through community partners, making it possible to engage and serve more youth.

The first UPRISE site to launch was Judith S. Kaye High School in Manhattan shortly before the COVID-19 pandemic. The program was then expanded to the co-located School of Cooperative Technical Education, which serves 1,500 students. Today, CARES serves more than 175 youth per year, delivering about 10,000 units of mental health service and 5,000 units of substance abuse service per year.

Expansion Plans and Challenges

The CARES Academy program has ambitious growth plans underway, including introducing it at the Judith S. Kaye High School in Queens in January 2026. But Dr. Taufique is particularly excited about the upcoming launch at YSOW.

“Because it is not a school setting, it allows us to show very clearly and concretely that we can apply the CARES model in a variety of ways,” she says.

The CARES model has changed over the years, incorporating trauma-informed approaches to therapy and shifting from an emphasis on achieving abstinence among substance users to harm reduction. These changes are informed by ongoing review not just of outcome measures but also through interrogating the trends that are informing them.

Dr. Taufique wants to evolve the CARES model further, but there are challenges that need to be addressed, such as securing the necessary funding to support their programming and training efforts and a growing waitlist for services.

She and the team are rising to these challenges, starting with a relocation to a new, larger space on West 38^th Street in Manhattan in September and the identification of new funding resources. This is enabling her to look at new initiatives, such as formalized therapeutic care for patients of CARES, and at launching new UPRISE sites in the city. But there are also opportunities to partner with former staff to adopt the model for health care systems and community-based organizations nationwide. The possibilities, she believes, are limitless.

“We want to enter different settings and say, ‘We can give you elements of care that may be beneficial to you and weave them into a program that works for you,’” she says. “I want to create a network of UPRISEs, all supported by the CARES hub.”