This paper reports on the current state of elementary school student mental health needs assessment and makes recommendations for future school counseling research and practice. The review of the theoretical literature on needs assessment examines several studies by numerous researchers. With one exception, all instruments reviewed were generated solely from an adult perspective. The data produced tended to be more indicative of adults' conceptualization of children's needs. Many of the quantitative studies reviewed also exhibited this same limitation. These studies failed to employ rigorous sampling methodologies, which reduced the scope and definition of children's needs to the researchers' own concepts of children's needs. Other intervening variables concerning needs assessment are also discussed. In order to aid school counselors in better serving their students, future studies should focus on children's attitudes, as opposed to adults perceptions of such, and take into account previously neglected factors such as differences in age or grade level of the children, gender, and cultural diversity. Contains 51 references. (BF)