Witnesses document a significant increase in the number of adolescents admitted to inpatient private mental health care, particularly in the psychiatric units of general hospitals, in recent years. Many witnesses attribute this to increasing health care insurance coverage for inpatient mental health services, the deinstitutionalization of troubled youth in juvenile justice facilities, and State mandates for inpatient mental health coverage. One concern in this trend is that families with insurance coverage for such services are using private mental health facilities for their troubled children while troubled juveniles from low-income families without insurance coverage end up in the juvenile justice system and juvenile correctional facilities. Another concern is that many juvenile psychiatric admissions are unnecessary due to loose diagnostic and admission criteria and the absence of appropriate outpatient services. Testimony suggests how States may address the negative aspects of these trends and how private mental health groups and institutions may improve their admission and treatment procedures. Supplementary materials and written statements.