This paper describes the development of emergency mental health services for children and adolescents in Lithuania over the past decade. The dramatic changes in child and adolescent psychiatry which correspond to the move away from the Soviet school to democracy and the restoration of the independent Lithuanian state are outlined. The paper includes: the nature of child mental health emergencies in Lithuania, how they are evaluated, follow-up care, training and supervision, and societal emergencies. Recommendations for the future are made.