The three-floor brick building in North Avondale used to be a nursing home for aged and blind African-Americans.

        Today, after nearly two years of planning and $700,000 in renovations, officials celebrate reopening the building as the Light house Residential Center, one of the few places in Greater Cincinnati where troubled teen-age boys can receive long-term, live-in treatment.

        Lighthouse Youth Services is to be commended for taking on a project that is so desperately needed in this community, said Don Hoffman, president of the Health Foundation of Greater Cin cinnati, a charity that helped finance the startup.

        On Sunday, an Enquirer analysis revealed Cincinnati lags behind many cities its size in providing services for teens with mental illness and substance-abuse problems. In recent years, many teens with extreme problems have been sent out of town for the kind of care now offered at the Lighthouse Residential Center.

        “That's exactly why we've opened this facility,” said Robert Mecum, executive director of Lighthouse Youth Services. “There's nothing in this town between crisis stabilization care (at a psychiatric hospital) and home. We're using local tax money to pay for out-of-town care.”

        In most cases, the boys who will live at the Light house center have been placed in county custody and gone through several rounds of less extreme treatment.

        They've been abused physically or sexually. They've been diagnosed with depression, bipolar disorder, and other extreme behavior disorders. They've abused drugs and alcohol.

        They've bounced around in foster homes, been kicked out of schools and charged with juvenile crimes. They've been in and out of psychiatric hospitals and outpatient counseling programs.

        To make a long-lasting difference, experts say these troubled teens need to be removed from unhealthy, unsafe home settings to spend weeks, months, even years in small group homes where counseling, medications and basic life-skills training can be provided nonstop.

        Until now, Hamilton County agencies, through a program called Creative Connections, have been sending their most extreme cases to facilities in Athens, Ohio, Columbus, Indianapolis and other cities.

        While those services often provide good care, out-of-town treatment makes it hard for loved ones to stay in touch. It also makes it harder to arrange follow-up care once the child comes back to Cincinnati.

        “This is damned hard work,” Mr. Mecum said. “We're working with people a lot of folks would rather not think about. Without a place like this, these people either get sent out of town or they wind up in psychiatric hospitals or they wind up in jail.”

        Up to 12 boys at a time will stay about three to five months at the Lighthouse center, longer if needed. While there, they will attend an affiliated charter school, receive individual counseling and participate in group sessions every morning and most evenings.

        Mr. Mecum projects Lighthouse services will cost about $250 a day, about half as much as some out-of-town agencies charge, he said.

        While this program focuses on boys, a similar Lighthouse program has served girls for the past several years, Mr. Mecum said.

        While praising the new Lighthouse center as one more option, people familiar with the system say it won't meet the entire local demand for teen mental health and substance-abuse treatment.

        Mr. Hoffman said at least two more similar centers are needed, one in Northern Kentucky and one in Butler or Warren counties.

        “The Health Foundation serves 20 counties. This is only one piece of it,” Mr. Hoffman said.

        Even in Hamilton County, the Lighthouse project will not compete with plans at Children's Hospital Medical Center to build a 36-bed long-term residential center for mentally ill youth, said Dr. Randy Sallee, the hospital's director of psychiatry.

        “We're still working on (treatment center) plans,” Dr. Sallee said. “Their project sounds great. But it probably won't be enough all by itself.”

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