A child's mental illness is one of society's most difficult challenges and society's response could make the challenge almost impossible. Children's mental health needs are unmet and they become isolated from their families and communities, causing a failure across youth-serving institutions. This article attempted to highlight the problem of children's mental health and the unmet needs, the government's poor coordinated response to mental health needs, and the tools being used to improve accountability and outcomes. Mental health disorders of children constitute a serious public health challenge. The most common cause of hospitalization among young adults is mental illness. When psychiatric needs and treatment go unmet, extensive failure in family relationships and child-serving institutions are created. A fractured system of care, limited access to individualized treatment, an isolating over-reliance on restrictive care, and insufficient resources are causing the enormous gap between provided treatment and children's needs. Advocates need to hold agencies more accountable through partnerships providing at-risk youth with a right-of-way at agency intersections. In addition, accountability offers increased program coordination, more individualized services, less restrictive care, and increased positive outcomes.