OBJECTIVE: This study estimated the prevalence of mental health problems among clients of domestic violence programs in North Carolina, determined whether domestic violence program staff members routinely screen clients for mental health problems, described how domestic violence programs respond to clients who have mental health problems, and ascertained whether domestic violence program staff members and volunteers have been trained in mental health-related issues. METHODS: A survey was mailed to all known domestic violence programs in North Carolina. RESULTS: A total of 71 of the 84 known programs responded to the survey (85 percent response rate). A majority of programs estimated that at least 25 percent of their clients had mental health problems (61 percent) and stated that they routinely asked their clients about mental health issues (72 percent). More than half the programs (54 percent) reported that less than 25 percent of their staff members and volunteers had formal training on mental health issues. An even smaller percentage of programs (23 percent) reported that they had a memorandum of agreement with a local mental health center. CONCLUSIONS: The substantial percentage of domestic violence clients with concurrent mental health needs and the limited mental health services that are currently available have important implications for domestic violence and mental health service delivery.