The purpose of this article is to present selected findings from a case study of systemic facilitators of, and barriers to, full implementation of Project Success. This project was designed to prevent the development of serious emotional disturbance (SED) in at-risk children in the early elementary grades. The project involved (1) an intervention composed of classroom interventions, use of multiple services located on school grounds, and provision of case management services to the children and their families; and (2) a qualitative case study of systemic facilitators and barriers regarding implementation of the intervention. This article focuses on the second component, specifically on how and why the move toward managed care in provision of mental health services in general and in the Medicaid program in particular frustrated efforts to prevent the development of SED in young children with existing emotional and behavioral problems.
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