Findings of a study of mental health visits to general hospital outpatient clinics and emergency rooms by elderly persons and younger adults were compared with findings from an earlier survey of mental health visits to officebased physicians. In both studies, about half of the visits were to psy chiatric clinics or to psychiatrists. However, the findings differed in that 43 percent of all visits to hospital clinics were for substance abuse, compared with only 4 percent of the visits to private physicians. Almost three-fourths of the hospital-based mental health visits by elderly patients were to psychiatric clinics, while only a third of the office visits by elderly patients were to psychiatrists. The authors discuss the policy implications of the high utilization of clinic services by elderly patients.