This paper discusses the results of a study that investigated the effectiveness of four Elementary Mental Health Operations (ELMHO) programs in Pinellas County, Florida. ELMHO programs were designed to provide school-based mental health services to children and their families to help elementary students with emotional disabilities learn to cope with their issues well enough to mainstream back into less restrictive academic settings. The programs addressed: (1) the child's behavioral problems and level of functioning through individual, group, and family counseling; (2) identified family programs through parent training and family counseling; and (3) consultation with teachers to help them develop problem solving strategies to work with these children. The evaluation of this program consisted of interviews with 62 parents, principals, social workers, and agency staff, school record reviews of participating students (n=369), 100 case record reviews, and 11 case studies. Results indicated participants stayed in the program longer than was originally intended, children with the most severe rather than mild to moderate disabilities were referred to the program, family involvement in the intervention was critical to significant progress, and more families/siblings needed to be involved. (CR)