The age period of adolescence is significant for epidemiologic research because of the emergence of emotional and behavioral problems, which occur during this time. Many studies have shown that few of the adolescents identified as suffering significant psychological disturbance receive help from specialist mental health agencies. The recognition of this gap between identified need in the community and the utilisation of services underlies the pathways model proposed by Goldberg and Huxley (1980). Understanding the pathways by which the distressed person reaches specialist services may assist in the improvement of the quality of mental health care in the community. The studies of pathways have mainly focused on adult populations. However the dominant patterns of General Practitioner and Medical pathways found in these studies are inconsistent with those of adolescents. Their different level of social and emotional development affects both how they seek help and how their problems are perceived by significant others. This study examined the records of initial contact for adolescents aged 12 to 18 years, who were referred to three community based mental health clinics serving a regional health district of Brisbane, during the period of 1 June 1997 to 30 June, 1998. The results showed that the pathways by which adolescents reach mental health services were broader in scope than those of adults. Parent, Education Professionals and General Practitioners were the dominant pathways to service. The factors most commonly presented to mental health services at the initiation of help seeking were familial/life event problems and behavioral problems. A notable feature in the presentations was the alarming and disturbing quality of a substantial proportion of the identified problems. It is considered that the social impact of the problems is a strong precipitant in referral. The significant findings of the study are that the pathways vary by the age and sex of the adolescent, and that some presentation problems are more highly associated with particular pathways.