In Massachusetts and across the country, children with mental health needs now receive most of their care in their homes and communities. Much has been written about the value of this shift away from out-of-home care. Less attention has been given to how this shift has led to increased burdens on families. PPAL survey 280 families to better understand their need for respite care services, the value they place on these services, and the challenges they face in accessing these services. In, Respite Care: What Families Say families overwhelmingly report that there is a need for appropriate and affordable respite care. Most families have not been able to access respite services.