In the past 5 years, the juvenile justice system has been faced with alarming increases in the number of offenders with mental impairments, a rate considerably higher than in the general population. Estimates suggest that perhaps as much as 60 percent of youths in the system have a conduct disorder. The rate of psychotic disorders ranges from 1 percent to 6 percent. Attention deficit, affective and substance abuse disorders are also significant problems. The needs of these youths are unmet by a confused system of care that lacks the ability to adequately assess and address their need for mental health services. Other aspects of the problem include the disparity in access to treatment; minority children and adolescents are underserved or inappropriately served by the child mental health system. The article describes several Texas programs to serve the needs of juvenile offenders with mental impairments and emotional and behavioral problems. References