This monograph describes Families First, a family-designed system of mental health care for children in Essex County, New York. Philosophical principles of family-driven service delivery are outlined and illustrated with comments from participants. The planning that went into developing the Families First program is described, including initial outreach and funding, interviews with family members to assess their needs, and the establishment of a parent planning committee and an interagency task force. Priorities identified by families include respite care; advocacy services; information and referral; parent and sibling support; a family center; crisis services; and assistance with transportation, telephone connections, and medication costs. Provisions developed to meet each of these needs are described, as are social and recreational events, individualized family planning meetings, youth activities, and the project's newsletter. Principles established through the program's experiences are then summed up, including full inclusion of families as service designers, elimination of waiting lists, meaningful record keeping, and creative use of existing resources. Barriers to implementation of such programs are identified and discussed, followed by frequently asked questions and advice from parents. An appendix lists suggested materials to help launch such programs. (Contains 59 references.) (PB)