Background: Population and service characteristics were compared for youth (age 0-18 years) with and without schizophrenia-spectrum disorders, who received public mental health services in Hawaii's comprehensive system of care between July 1, 2000 and June 30, 2001. Methods: Electronic records of youth with a diagnosis in the schizophrenia-spectrum (n = 71) were compared to all other youth (n = 13,904) who received services with respect to age, gender, ethnicity, comorbidity, type of service, and service cost. Results: The schizophrenia-spectrum group had higher Asian representation, greater comorbidity, and was more likely to receive restrictive services for a higher average annual expense. When restrictive services were provided, they were of similar duration and intensity across groups. Almost all youth received less intensive services, but the schizophrenia-spectrum group received a higher frequency or longer duration of such services. Conclusions: Although youth with schizophrenia-spectrum disorders were uncommon, collectively they represented a distinct population with above average service consumption. Future monitoring of interventions and outcomes may help develop systematic and effective treatment strategies for youth with schizophrenia-spectrum disorders.