It is estimated that 7.5 million children in the United States do not receive the mental health services they need (Flisher et al., 1997; Kataoka et al, 2002). This is alarming given the negative outcomes for children with untreated mental health disorders. The purpose of this study was to determine the mental health needs of a group of youth in alternative high schools across Iowa. Additionally, this study served to assess whether the youth in alternative high schools differed in mental needs compared to those in traditional high schools and examined gender differences. To date, there is data available for 191 youth who were enrolled in alternative high school in Iowa. These students completed the Symptom Checklist 90-R. Preliminary data for different schools indicated that a majority of the youth were at significant risk for serious mental health problems. The information gained from this research should help alert educators, psychologists, and politicians to the necessity of mental health interventions in alternative high schools. The next step in this multi-faceted study will be to survey the mental health needs of youth enrolled in traditional high schools across Iowa.