What Works: System Development Strategies Across Communities

Methods This study used a multi-site embedded case study design. Participating systems were identified through a national nomination process and were selected on the basis of having: (1) an identified local population(s) of youth with serious emotional disturbance; (2) clearly identified goals for this population that are consistent with system-of-care values and principles; (3) active implementation of strategies to achieve these goals; (4) outcome information demonstrating progress toward these goals; and (5) demonstrated sustainability over time. Data collection included semi-structured key informant interviews, document review, site-based observation, and documented aggregate outcome data related to system implementation in communities with established service systems. The study included a total of six cases. Analysis used an intensive and iterative teambased approach.