Children with mild to serious mental health and emotional disorders are "in trouble" not only by virtue of committing a delinquent act, but by the neglect of their needs from other public institutions, including mental health agencies and schools. Psychiatric nurses have long advocated for children with mental disorders, but few have gone behind bars to advocate for these youth. This paper offered suggestions for advocating on behalf of the most underserved of children, youthful offenders with those efforts undertaken in the State of Maryland, as an example. The paper begins with an overview of children living in poverty, and how race and poverty determine the definitions of "troubled" and "in trouble." It continued with a look at incarceration and retribution instead of treatment and rehabilitation. The paper concluded with a discussion on the juvenile justice system becoming an advocate, specifically an advocate for appropriate systems for youthful offenders. "Troubled kids in trouble" are children with mental health needs in the juvenile justice system. A child with an emotional or behavioral condition, or substance abuse or alcohol problem has a legal right to treatment, and a need for services. The advocacy for children on both an individual and system-wide basis can lead to services that would keep these children from being "troubled" and being "in trouble." Tables and references