Summary: Recent publications and meetings highlight a great concern about the well-being of youth with serious emotional disturbance as they enter adulthood. The literature provides ample evidence that these young people struggle tremendously in meeting society’s expectations that they complete high school, get jobs, move out of the family home, become adult members of the community, and stay out of trouble. Testimonials from these youth and their families attest to the many challenges they face in achieving these goals. Unhappily one of the common challenges most often mentioned is an inadequate system response to their needs. Studies confirm that after age 16, and particularly after age 18, youth who have received significant supportive services often stop receiving these services. Furthermore, youth want many services but are unable to obtain them. Although numerous exemplary services have been developed for this population, these services appear to be offered on an extremely limited basis. This report summarizes findings from interviews with members of the Children, Youth and Families Division of the National Association of State Mental Health Program Directors. These members were reporting on transition-related activities in their states, focusing on efforts by state child mental health systems.