Children in the United States are facing unprecedented mental health challenges. In October 2021, First Focus on Children joined other leading children's health organizations to declare a national state of emergency regarding child mental health in the Sound the Alarm campaign, and in December 2021, the U.S. Surgeon General issued an advisory titled "Protecting Youth Mental Health" which precipitated a wave of hearings and legislation by Congress. This fact sheet discusses significant barriers to mental health services and presents recommendations.