After a study of almost complete patient populations at selected child and adolescent psychiatric facilities as part of the federal government's "Modellprogramm Psychiatrie", two groups of children were investigated with the Child Behavior Checklist: a representative sample of 1969 school children between 6 and 17 years of age and 404 patients from child and adolescent psychiatric services. The presence of psychiatric problems was based on symptoms reported by the parents that experts rated as requiring treatment (at least two critical items). Of the 1969 school children, 253 (12.7%) required counseling or treatment, but only 64 (3.3%) were being treated for psychiatric problems or a developmental delay, half of them at non-psychiatric medical facilities. Symptoms prevalence correlated with age, social class, type of school and nationality.