Carson and colleagues reviewed 252 outpatient charts from five community clinics in an urban area of the northeastern United States to compare how Haitian, African American and non-Latino White young people used mental health care during their first six months of treatment. Retention drives the findings. Most Black patients in both groups had stopped attending by six months, usually after fewer than eight sessions, and about a third came only once. Scored against published guidelines for attention deficit hyperactivity disorder and for depressive disorders, Haitian patients were least likely to receive adequate treatment, with White patients roughly four times likelier on both measures once clinical severity was taken into account. Haitian youth were also more often uninsured, more often given adjustment disorder diagnoses, and more often recorded as separated from a parent through migration. The authors weigh insurance cost, a family threshold of perceived need before seeking help, and diagnostic hesitancy in cross-cultural encounters.