Abstract
Reviews selected issues relevant to the provision of mental health services in pediatric primary care settings for disadvantaged children and families. Multiple sources of data suggest that pediatricians constitute a de facto mental health service for many disadvantaged children and that it is critical to undertake efforts to enhance and functionally integrate this resource into our existing system of care. The problems faced by disadvantaged families in need of mental health services are outlined. Major service access and utilization problems are highlighted, and prospects for improved service delivery are discussed.