The consultative study is one model of academic involvement in public mental health services. However, the effects of consultation and how it acts as a catalyst for change have been poorly documented. The authors describe a consultative study in which a team from an academic training center examined the system of mental health and related human services for children and adolescents in a semirural county in western Pennsylvania. They also present results of a six-year follow-up survey assessing the study's effects. Improvement in the system of care during the follow-up period included creation and maintenance of a children's unit and a partial hospital program for adolescents at the county's community mental health center. The consultative study and the follow-up survey were instrumental in establishing a comprehensive range of services, including intensive case management for severely disturbed youngsters and a home-based mental health services program.