A chart review was done in 3 community mental health centres & an emergency room to compare psychiatric diagnoses given to youths as outpatients with those they had previously received as inpatients. 63% of 54 admissions were due to suicidal ideation or threats. Major disparities were found between the 2 sets of diagnoses. A profound underdiagnosis of conduct disorder & a selective overdiagnosis of unipolar depression occurred in hospitals. Implications of the findings are discussed. (13 refs.)