Objective: The purpose of this study is to assess the reliability and validity of the North Carolina Family Assessment Scale (NCFAS) among families involved with youth mental health services. Methods: Using NCFAS data collected by child mental health intake workers with 158 families, factor analysis was conducted to assess factor structure, and thematic analysis of intake notes was used to test content validity. Results: This study found only three NCFAS subscales. The case notes included themes specific to youth with mental health needs that were not captured by current NCFAS items. Conclusions: This study suggests variation in the fit for the NCFAS in child mental health services compared to the measurement properties established in child welfare samples. (Contains 4 tables.)