Increases in emergency use rates for mental health care by children and youth are emblematic of problems with access to community-based mental health services and supports. These visits further stretch an overextended emergency health care system. Emergency departments are poorly equipped to address the mental health needs of children, youth, and their families who seek psychiatric attention. While they encounter challenges meeting the need for pediatric and adolescent services, they are even less prepared to provide pediatric and adolescent mental health care. This issue brief reviews the state of mental health services for children and youth who visit hospital emergency departments for mental health-related reasons and provides an overview of the challenges associated with mental health-related emergency department visits. It discusses the policy implications of using emergency department services for mental health reasons for children and youth and makes recommendations for policy action.