Thirty-seven of 43 (86%) agencies operating child welfare residential treatment centers in New York State responded to a survey about the provision of mental health services. Questions were asked about provision of services, satisfaction with services, and suggestions for improvement in five domains: therapeutic milieu, individual therapy, group therapy, family therapy, and psychiatric services. Results revealed that due to funding constraints most agencies reported hiring direct care staff with limited formal education to work with children who present with increasing intensity and severity of emotional and behavioral problems, which in part led to high turnover rates and moderate levels of satisfaction with services. Taken together, the data highlight the demands on the system as more severely troubled youth are being served with fewer dollars provided for their care. The findings suggest many avenues for advocacy, clinical intervention, staff development, and further research. (Contains 6 tables.)