<h3>Background</h3> While 10% of 5–15 year olds in the UK have a mental health disorder, only a small proportion use specialist services. Children with mental health problems can present to child mental health services (CAMHS), paediatricians or both. The Children9s Services Mapping now collects data on numbers and case mix presenting to CAMHS services in England. No routine statistics are collected on those presenting to paediatricians. <h3>Aim</h3> To analyse the number and nature of mental health disorders presenting to paediatric outpatients in district A. <h3>Method</h3> Data were collected prospectively from 1.2.06–31.5.06. Disorders were classified using the CAMHS mapping categories. <h3>Results</h3> 123 (one in six) children presented with a mental health disorder (referral rate: 6 per 1000 children aged <15 per year). Community paediatricians saw 111 (90%) cases including attention deficit hyperactive disorder (ADHD) (59), autism spectrum disorder (ASD) (17) and emotional/behaviour disorders (35). General paediatricians offered appointments to 12 cases including emotional disorders (4), habit disorder (2) and behavioural difficulties (1). Five referrals did not attend. Eight referrals had been duplicated to CAMHS. After assessment, another 15 (13%) children were referred on to CAMHS by community paediatricians—mostly for specific services for ADHD and ASD. <h3>Conclusion</h3> This study gives a unique insight into mental health disorders presenting to UK paediatricians.