The sample used in this study was part of a larger study of psychopathology and the use of mental health services in a Dutch national sample of children and adolescents. If the subject was 11 years old or older, he/she was asked to complete the Youth Self-Report (YSR), which was used to obtain standardized adolescent self-reports of problem behaviors and competencies over the preceding 6 months. Adolescents also completed a questionnaire that focused on demographics, self-perceived need for help, unmet need, and referral for mental health services. A total of 1,120 adolescents aged 11 to 18 completed the questionnaires. Findings showed that 3.1 percent of the sample had been referred for mental health services within the preceding year; and 3.8 percent reported having unmet need; 7.7 percent of the adolescents at risk for psychopathology and 17.8 percent of those indicating a need for help had been referred. Family stress and adolescents' self-reported problems were most strongly associated with service need and use. Internalizing problems, female gender, and low education level were associated with self-perceived unmet need. Adolescent ethnicity and competence in activities and school were associated with service use, but did not influence service need; the opposite effect was found for adolescent age and parental psychopathology. The study concluded that in designing intervention programs aimed at increasing adolescent mental health service use, distinctions should be made between efforts that focus on adolescents who do not recognize their problems and those who recognize they have unmet needs. 3 tables and 28 references