Due to extraneous circumstances experienced by children and youth in the child welfare system, studies indicate that a significant number of children in foster care exhibit mental health problems that require mental health intervention. While utilization of mental health services has been viewed as critical to the well being of children while in foster care, not all foster care children receive the mental health services they need and little is known of the utilization of services by this population. One area that lacks attention and may help explain the under utilization of mental health services is the influence that the caregiver has on a child's utilization of services. Caregivers serve as gatekeepers for children while in the child welfare system, but few studies have focused on the factors that influence a caregiver's use of mental health services for the children under their care. The extant literature with caregivers has generally only focused on need and predisposing factors of kin caregivers to predict utilization of mental health services for children in foster care. However, research studies with caregivers in community samples indicate that a caregiver's perceptions and knowledge of mental health services is significant in whether children under their care utilize mental health services. Therefore, the specific aims of this study are: a) to examine the impact of predisposing factors on need factors and the impact of need and predisposing factors on mental health service use by caregivers for the children and youth under their care, b) to determine whether caregivers' perceptions and knowledge of mental health services mediates the relationships between need and predisposing factors and mental health service use by caregivers for the children and youth under their care, and 3) to investigate whether the mediation pathway from need and predisposing factors to perceptions and knowledge of mental health services to mental health service use by caregivers for the children and youth under their care differs among caregiver type. The Patterns of Care Study (POC) conducted of youth in five public sectors of care, which examined need and utilization of mental health services by children and youth and their parent/caregiver, will be used for this study. The child welfare data will be derived from the parent study and secondary data analyses will be conducted using structural equation modeling with a mediating-moderating effect. [unreadable] [unreadable] [unreadable]