How do you determine the problem with a 1986 Honda Accord DX 4-door that has a high pitched ticking coming from the belt area of the engine?

Hey Josh==It sounds like you have a bearing going out of a water pump or alternator. The best way is to get a stethescope for about$20. it makes short work of finding noises. Or you can get a 3 foot length of hose and listen at one end while moving the other around to different spots to find the noise. If you can take a belt off of the alternator and still have the water pump turn, that may do it. Goodluck Joe

It's also possible that the noise you are hearing is just the valve-train. Does the noise go away or get quieter once the engine is warmed up? Does the speed of the ticking increase with engine RPM?

If it a big concern, a qualified mechanic will be able to tell you if it's the valves or not just by listening.