Abstract When a child is diagnosed with a significant health problem, they and their families are at increased risk of experiencing psychological distress and disorder. The objectives of this study were twofold: firstly, they were to examine the relationships amongst child illness, parental and child distress, quality of life and medical regimen adherence; and secondly, to understand the degree of parent interest in receiving psychological support and paediatricians' perceptions of family psychosocial needs. Participants were 152 parents of children utilising a paediatric outpatient clinic who completed a battery of self-report questionnaires including the Depression Anxiety Stress Scale, Quality of Life Scale, and Strengths and Difficulties Questionnaire. Information regarding demographics and child health status were collected and paediatricians completed a measure of health status, medication adherence and perceived need for psychosocial support for each participant. Parent ratings of stress symptoms were significantly higher than in normative populations and their children were rated as having a significant degree of emotional, hyperactivity, conduct and peer problems. Increased levels of depression, stress and anxiety in parents were associated with higher ratings of child hyperactivity and peer problems. Parent stress and anxiety levels were also related to emotional symptoms in children. A large proportion of the sample perceived paediatric psychology services as being important and were interested in accessing such support. Parent interest was associated with having an older child, congenital illness, elevated distress scores on the Depression Anxiety Stress Scale and higher mean ratings of quality of life. Paediatricians suggested that many families could benefit from psychosocial input for issues relating to their child's health problem and child's age and quality of life were shown to also account for a large proportion of the variance in these ratings. Implications for the delivery of paediatric health psychology services are discussed.