School-based mental health practitioners are positioned to address low-income urban African American girls' mental health needs through culturally responsive services. Despite the importance of culturally reflective practice, it is understudied. We asked school-based mental health practitioners (N = 7) to reflect on barriers and facilitators to culturally responsive services and on their perceptions of the African American girls they serve. In-depth interview data were analyzed using an inductive-deductive model. Major themes were discerned using pattern analysis. Participants described exposure to violence, limited trusting relationships, depression, and low self-esteem as girls' main problems but saw girls as resilient despite limited access to mental health supports. Perceived barriers to mental health service provision included limited resources and higher prioritization of academic achievement. Although participants reported limited diversity training, they reported using culturally responsive strategies. Participants indicated a need for more collaboration and training to meet girls' needs. We discuss implications for practitioners.