To assess children's mental health service needs and utilization patterns for a state planning effort, a cross-sectional survey that sampled 822 children aged 6 to 11 of a metropolitan center was conducted. When reports of parents and teachers were combined, 38.5% of children were screened to be at risk of psychiatric disturbance. Only 11% of children at risk received treatment in mental health settings, fewer than in schools (37%) or medical settings (13%). The findings illustrate the importance of interagency collaboration and the need to consider reports of parents and teachers and different dimensions of psychopathology in future planning and research.