OBJECTIVE: To systematically screen for behavioral and mental health problems and psychosocial stressors (PS) in newly referred patients and adult caregivers (PACs) in a pediatric weight management program. METHODS: We used the Strengths and Difficulties Questionnaire (SDQ), the Center for Epidemiologic Studies Depression Scale (CES-D) for caregivers and patients >/=18 years, and assessed urgent mental health concerns and psychosocial stressors. RESULTS: A total of 243 PACs were screened; data were unavailable for 6. Compared with US normative data for the SDQ-Parent Proxy Version, the proportion of patients in our sample with borderline/abnormal total difficulties and conduct problems scores was greater for all age groups. Among adult caregivers with complete CES-D, 18.4% were at risk for depression. Eleven percent of patients screened positive for urgent mental health problems. Overall, 43% of patients and 57.4% of caregivers had PS. CONCLUSIONS: Systematic screening identified untreated symptoms and significant PS. Addressing these complex problems likely requires collaborative approaches with community providers.