This paper uses data from a project in South Carolina that provides services to children with severe emotional disturbance (SED) to examine the role of schools in integrated service delivery. This study examined organizations participating in a demonstration project sponsored by the federal Center for Mental Health Services and administered by a mental health center in an urban area of South Carolina. A systems-level assessment measured differences in development and coordination among service organizations in the demonstration site (n=61) and its comparison community (n=39). In the urban demonstration site, organizations serving children with SED were coordinated through a system of care model and featured multi-systemic therapy, an ecological treatment model. Results of the study indicate schools were important service providers for children with SED, but they were not always highly integrated within a larger system of child mental health services. School-based mental health counselors, however, played an important role in bringing schools into the system of care, primarily through increased client referrals. The presence of school-based mental health counselors was associated with more than twice as many client referrals and almost twice as many information exchanges from schools. (Contains 21 references.) (CR)