In disputes regarding children and families, such as custody arrangements or conditions of probation or confinement, the standard for resolving the case in most jurisdictions is the best interest of the child, leaving virtually unbridled discretion in the hands of the trial judge. This general indeterminacy in juvenile and family law applies specifically to child mental health issues. When a child is brought into juvenile court, the probability is high that some form of mental health treatment will be recommended by clinician on a largely unreviewed assessment of need for treatment. Even assuming reliability of diagnosis, there is apt to be little basis for determining the match between individual juvenile and available services. Legislatures and judges must decide how to allocate decisionmaking responsibility among child, parents, and state. The lack of forthright decisionmaking may be explained by the fact that the nature of the interests at stake often is unclear in children's cases, the courts avoid hard choices that are inherent in clashes among the autonomy of youth, privacy of families, and welfare of youth, and courts overlook the realities of children's cases in order to reach symbolic decisions. The lack of planning in child mental health policy reflects not only conflicts of values and social trends (such as family privacy and the state intervention to protect the child). It also results from the overdifferentiation of children's services. Careful interdisciplinary consideration of child mental health policy will result in a system of services that is more effective and more just. 7 footnotes and 39 references.