Access to child and adolescent psychiatric services in many rural areas is limited by lack of physicians and long travel times. A child and adolescent telepsychiatry clinic that is part of the University of Kansas Medical Center's telemedicine program addresses this problem by linking the medical center with a county mental health center in rural Pittsburg, Kansas. The clinic receives ten to 18 visits a week and has been able to serve severely disturbed children and children in crisis. The quality of clinical interactions in the telepsychiatry clinic appears comparable to that in face-to-face meetings.