This chapter discusses the challenges and opportunities associated with building a practice for child mental health services in Liberia. For children and youth in post-conflict settings such as Liberia, mental health services are almost non-existent, despite the greater need. The chapter focuses on the research on child and adolescent mental health prevalence and the treatment gap for children and youth. The 2009 National Mental Health Policy provided a framework for children's mental health policy and practice. John F. Kennedy Medical Center (JFKMC) is the only tertiary care referral hospital in Liberia. The chapter outlines how services for children are currently organized at Grant Hospital, with outpatient services at JFKMC. A second source of specialty mental health in the JFKMC system is housed in its main ambulatory service. In conjunction with partners, JFKMC launched a child and maternal mental health consultation service in early 2012.