Ninety percent of the world’s children and adolescents live in low resource countries; and nearly one-half of all mental disorders begin before age 14. The prevalence of child and adolescent mental disorders in low resource countries is around 20%. Fewer than 25% of children and adolescents with psychiatric disorders receive treatment. Resources are insufficient, inequitably distributed, and inefficiently utilized; treatment and care are often neither evidence based nor of comprehensive or of high quality. Nationally, child and adolescent mental health policies and standardized training are virtually nonexistent. This article highlights the challenges faced and discusses measures to overcome them.