Five out of every 100 children develop serious emotional disturbances. Another 20 to 25 out of every 100 develop less severe emotional problems that can be resolved with proper care. It is this group for whom appropriate intervention can make a difference. This booklet describes the Great Smoky Mountains Study, a longitudinal, population-based community survey of children and adolescents in North Carolina. It summarizes the first component to yield findings, and provides information about rates of emotional and behavioral disorders and use of mental health services. It also provides policy-relevant information in the areas of the need for mental health services, risks for emotional and behavioral disorders, outcomes of serious emotional disorders, use of mental health services across sectors, and effectiveness of mental health care. It considers the impact of insurance on the availability and delivery of services. A summary of the recommendations for action include: (1) increase professional mental health resources in schools; (2) adopt standardized assessment methods and instruments for early detection; (3) take steps to enhance interagency relationships; and (4) incorporate need for services into policy as the criterion for use. (JDM)