ORIGINAL PAPER Implementation and Utilization Characteristics of a Rural, School-linked Mental Health Program Garret D. Evans Æ Heidi Liss Radunovich Æ Michelle M. Cornette Æ Brenda A. Wiens Æ Antara Roy Published online: 13 August 2007 Ó Springer Science+Business Media, LLC 2007 Abstract We examined variables associated with treatment engagement in a real- world therapeutic setting. The model of care examined involved school-linked mental health care for children and their families in a rural county. Service utili- zation characteristics, as well as child- and treatment-specific variables were examined in relation to their impact on therapy length, missed appointments, and treatment outcome. A total of 168 students and their families participated in ther- apeutic services over a period of approximately 4.5 years. Overall, children who had less psychopathology and a higher level of clinician-rated functioning (GAF) at the start of therapy were more likely to successfully complete treatment. Parental involvement in therapy was associated with a longer course of therapy, as well as more missed appointments. Barriers to treatment and treatment engagement, as well as future directions of study, are discussed. G. D. Evans Human Solutions Consulting, Gainesville, FL, USA H. L. Radunovich (&) Department of Family, Youth & Community Sciences, University of Florida, Box 110310, Gainesville, FL 32611-0310, USA e-mail: hliss@ufl.edu M. M. Cornette Department of Psychiatry, Clement J. Zablocki VA Medical Center, University of Wisconsin, Milwaukee, WI, USA M. M. Cornette Department of Psychiatry and Behavioral Medicine, University of Wisconsin, Milwaukee, WI, USA B. A. Wiens Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA A. Roy State University of New York at Buffalo, Buffalo, NY, USA 123 J Child Fam Stud (2008) 17:84–97 DOI 10.1007/s10826-007-9148-z