The purpose of the current study was to determine how students identified as Emotionally Disturbed (ED) with severe internalizing concerns who receive special education services are placed in different school districts throughout the country. Examining the variance in how this population is placed in different parts of the country is of significant concern as students who present with internalizing behaviors tend to be under-identified for these services. Participants included a convenience sample of 143 practicing school psychologists who were employed in a public-school setting. Participants were provided with three vignettes depicting different examples of students identified as ED with primarily internalizing symptomatology. The research questions were statistically analyzed via a chi square and multiple ANOVAs to compare the means among four different regions of the United States (Northeast, South, Midwest, and West). Most participants reported encountering a student with severe internalizing behaviors 1-5 times per year in their role as a school psychologist. A statistically significant difference was revealed for the likelihood that such students would be placed in a separate school for students with special needs; the likelihood that such a student would receive Tier 3 mental health support in their placement; and the level of the school psychologist's satisfaction with the available placement options in their district. The data revealed a noteworthy difference between the Northeast and South regions of the U. S. Specifically, participants from the Northeast reported having access to more comprehensive services than those from the South. These results also indicate that services for this type of student would not differ significantly from students with externalizing behaviors across the four regions of the United States. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]