This study examined the impact of a learning collaborative composed of five child mental health agencies which was conducted from November 2005 to November 2006 in a suburban community adjacent to New York City. Data submitted by each agency (in November/December 2005, and then monthly between April 2006 and November 2006) regarding: 1) initial show-rates for first intake appointments for all new evaluations of children and adolescents, and/or; 2) attendance at any scheduled clinic appointment subsequent to the first kept intake appointment, were retrospectively analyzed. Agencies reported an increase in kept initial appointments ranging from 5% to 21% over the previous year, while kept subsequent appointments evidenced an increase between 2% and 16%. In contrast, one site that did not administer the engagement strategies noted a decrease in both engagement and subsequent appointment rates during the course of the collaborative between 9% and 13% respectively. These findings support the effectiveness of learning collaboratives for improving service use among youth with mental health difficulties and their families.