A review of the history of the MHSPY notes that it stems from the National Institute of Mental Health's Child and Adolescent Service System Program, which mobilized States to envisage and plan multiagency systems of care for children with severe emotional, mental, and behavioral disturbances, along with their families. In 1988, the Robert Wood Johnson Foundation provided funding for the first implementation of these plans and visions. MHSPY sites were established in California, Kentucky, North Carolina, Ohio, Oregon, Pennsylvania, Vermont, and Wisconsin. This interim report on the eight projects describes their activities during the first 4 years of MHSPY. Each project is unique despite common interests in serving emotionally disturbed children and their families, creating organized systems of care for this patient population, and integrating the services of responsible agencies. Individual reports address each project's governance and organization, financing strategies, accomplishments, and plans for the future. A MHSPY composite system of care combines the valuable features achieved in the various sites and the ideals they attempted to fulfill as they built their systems of care. Appendixes contain a cross-site comparison of the MHSPY, outcomes of community-based systems of care, and MHSPY sites. Glossary and a 63-item bibliography