Many States and mental health advocacy organizations have recently reported the difficulty many parents have in accessing mental health services for their children with mental health needs. Due to this difficulty, parents have sought alternatives to keeping their children at home; these alternatives include potentially inappropriate placements in the child welfare and juvenile justice systems. This report, conducted by the U.S. General Accounting Office (GAO), set out to obtain estimates of the number and characteristics of children voluntarily placed in the child welfare and juvenile justice systems to receive mental health services through two surveys: (1) mail survey to State child welfare directors in the 50 States and the District of Columbia, and (2) a telephone survey of directors of county juvenile justice agencies in large counties in the 17 States with the largest populations of children under age 18. Responses from 19 States and juvenile justice officials in 30 counties estimated that in fiscal year 2001 parents in their jurisdictions placed over 12,700 children (mostly adolescent males) into child welfare or juvenile justice systems to receive mental health services. A variety of factors influenced whether parents placed their children in the child welfare and juvenile justice systems to receive services. Neither the child welfare nor the juvenile justice system was designed to serve children who have not been abused or neglected, or who have not committed a delinquent act.