Background: The Pennsylvania Youth Survey (PAYS) is administered biennially to adolescents; it covers knowledge, attitudes, and behaviors about risk and protective factors. Purpose: This study explored 8th, 10th, and 12th grade students' attitudes and beliefs about current trends regarding drugs, alcohol, and mental health. Methods: We asked persons a series of questions in semi-structured focus groups (102 participants) while they were being presented with the PAYS data. Results: Participants expressed significant insight on root causes of risk behaviors. They recommended a decreased emphasis on grades and class rank, and recommended addressing mental health stigma, educating about vaping and marijuana effects, and obtaining support from families, schools, and communities. Conclusion: Youth expressed interest in being an integral part of the planning and decision-making efforts that impact them. Our results support the Whole School, Community, and Child (WSCC) model.