This study examined whether African American and Caucasian male youths had similar rates of referral to mental health services in a juvenile justice secure facility when controlling for differences obtained in the initial screening and assessment process. Data from the Massachusetts Youth Screening Instrument-2 (MAYSI-2), Initial Health Care Screening and Youth Level of Services/Case Management Inventory were analyzed from 937 male youths (12-18 years old) admitted to a secure care facility. There were few differences between African American and Caucasian youths on MAYSI-2 scales and no difference on the YLS total score. However, Caucasian youth reported higher frequencies of mental health treatment history than African American youth. Even when controlling for differences in MAYSI-2 elevations and history of receiving mental health treatment, Caucasian youths were provided access to mental health services at a greater rate than African American youth. This study indicates that race is a potential factor in mental health service access for youth in a secure care setting. (Contains 4 tables.)