In Ontario, Canada, a wide range of services has been developed to support children and youth with severe mental health problems. After services have ended, many of these children continue to live with emotional and behavioral challenges. However, the clinical outcomes of children discharged from residential mental health centers and home-based alternatives are not well known. The purpose of this report was to document mental health outcomes from standardized measures of symptom severity and functioning of children and youth involved in residential treatment or a home-based alternative. In general, some clinical and psychosocial improvements from admission to discharge and follow up were revealed, although not all measures were statistically significant. Furthermore, many youth continued to function within the clinical range of impairment. Implications for mental health services are discussed. (Published Abstract)