Anecdotal and limited objective studies have indicated that children and youth being raised in nonparental settings, such as those with custodial grandparents or in foster care, show a higher need for mental health services. They are often prescribed psychotropic medications at a higher rate. The authors set out to study the prevalence of this trend in a sample group of suburban community health center child and adolescent patients who are being served through an outpatient school-based program of Prince William County, Virginia in the US.