The great majority of children living in foster or residential care have been abused and neglected. Mental health problems are common and the nature of these problems may be rooted in early attachment relationships. The carers of 82 children in care in Scotland and 125 children from local schools completed questionnaires on mental health problems including Reactive Attachment Disorder. More than half (53%) of the children in care fulfilled criteria for mental health problems compared with 13% of the control group, and children living in care scored significantly higher for conduct problems, emotional problems (anxiety and depression), hyperactivity, problems with peer relations and Reactive Attachment Disorder. This has important implications for service development for this vulnerable group of children. (Contains 1 table.)