Thousands of juveniles with mental health disorders enter the juvenile justice system every year. The Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2) is often used to assess them. The disproportionate numbers of African American youth in the juvenile justice system and the large numbers of youth with mental health needs necessitate accurate screening across racial groups, but recent evidence indicates that groups may be interpreting MAYSI-2 items differently. A total of 90 male juvenile detainees participated in a structured interview exploring what factors might mediate race and impact MAYSI-2 scores. Results confirmed which factors influence MAYSI-2 scores for African American participants. (Contains 2 tables and 4 figures.)