The Great Smoky Mountains Study (GSMS) was designed to examine the development of, need for, and use of mental health services in children and adolescents in an area of the southeastern United States. The study addresses the extent of met and unmet need for mental health care; the role played by education, primary care, child welfare and juvenile justice in the provision of mental health care for children; the interrelationship of diagnosis and functional impairment; individual, family and community predictors of need for mental health care; the impact of different service delivery systems in urban and rural communities; and the interplay of individual development and the development of need for and use of services. There are three main study goals: (1) to understand the developmental pathways of a large sample of children with a high need for mental health care; (2) to estimate the prevalence of disorders and risk factors in the population; (3) to map the identified cases onto the general population.
First, a screening-stratified sampling design was used. Those who had high ratings on the screening (indicating high externalizing scores) were all included in the sample. Those who had low screening scores were randomly selected to be part of the sample.