OBJECTIVE: Many studies of the prevalence of mental disorders among residents of long-term care facilities have had substantial methodological shortcomings. This study was conducted to replicate a previous well-designed study and to examine additional characteristics of nursing home residents. METHOD: Randomly selected residents (N = 80) in a public long-term care facility were evaluated by a psychiatric team using DSM-III-R criteria and quantitative assessments of behavior and cognitive status. RESULTS: Of the 80 subjects, 91% had at least one psychiatric diagnosis and at least one behavioral problem; 50% had four or more behavioral problems. In addition, 29% had received psychiatric care before admission, and 61% received psychiatric care after admission. CONCLUSIONS: These findings replicate those of the few prior studies that used analogous research techniques, but those previous studies were conducted in private, intermediate-care institutions whose residents had different demographic characteristics. The mental health needs of these residents are substantial and should be addressed by the medical community and the nursing home industry.