This report discusses the outcomes of a study that examined the mental health referral patterns of youth referred to a public sector mental health system as the result of a judicial consent decree. The study included two samples of youth ages 13-17 from the entire state of South Carolina. The first group included incarcerated youth recruited from the South Carolina Department of Juvenile Justice (SCDJJ) central detention facility in Columbia (n=120). The second group included youth referred to South Carolina Department of Mental Health (SCDMH) facilities as part of a judicial consent decree (n=120). Data were collected on both samples between January 1997 and December 1997. Findings from the study indicate there is a substantial level of need for mental health services among detained youth. Ninety-six percent of referred youth and 69 percent of incarcerated youth met criteria for a psychiatric disorder. The most common diagnostic category was disruptive disorder for both referred and detained youth. Referred youth were more likely to have affective diagnoses than detained youth; however, they were less likely to have a substance abuse disorder. Consistent with prior studies, African-American youth were referred for mental health services less often than were Caucasian youth. (Contains 16 references.) (CR)