An analysis of issues related to mentally ill juvenile offenders reviews the problems confronted by the juvenile justice system in obtaining jurisdiction and treatment for mentally ill juveniles involved in serious bodily injury or death. A discussion of the treatment of mentally disordered juvenile offenders examines the attitudes of institutional administrators toward mentally disordered and violent wards of the court, with emphasis on the reasons why they often do not receive treatment despite the best efforts of juvenile court judges to see that they do. Onsite visits to many treatment programs for serious juvenile offenders are the basis for descriptions of innovative alternatives to incarceration for youths committed by the San Diego County (California) juvenile court. A discussion of international variations in the treatment of serious juvenile delinquency uses the results of a 3-year survey of 37 nations. The analysis covers the Americas, Western and Eastern Europe, Africa, the Middle East, Asia, and Australia and New Zealand. Chapter reference lists and numerous recommendations are included.