Research has established that between 9 to 13 percent of children and adolescents in the United States suffer from a psychiatric disorder marked by significant functional impairment. Many proponents of mental health services for youth point out that schools are ideal locations to target mental health disorders and provide mental health services to young people. This study explored the perceptions of teachers regarding the need for school-based mental health services by distributing surveys to 119 teachers in 6 elementary schools in a major midwestern city. Survey questions focused on teachers’ perceptions of major health problems impacting their schools; barriers to overcoming these health problems; preferences for mental health topics for in-service education; and their experience, attitudes, and knowledge pertaining to mental health issues. Results of statistical analyses indicated that approximately 80 percent of young people needing mental health services received these services at school, mainly due to barriers to accessing conventional sources of care. Teachers reported their most salient mental health problem in school was students with emotional and behavioral problems who became disruptive to the school environment. A lack of education and resources were sited as the barriers to overcoming this problem. The clinical implications of the findings are discussed and include the creation of partnerships between schools and child psychiatrists. Figures, tables, references