Nationwide, a staggering number of young people suffer from diagnosable mental, emotional, or behavioral disorders. Most adult mental health issues begin in adolescence. Yet the majority of youth who need care do not receive it. Barriers to access include lack of or limited health insurance for mental health care, social stigma, and lack of problem recognition by adults, including teachers and parents/guardians. Under-identification is of particular concern in schools and primary care settings—two systems with which nearly all children interface and where identification can likely occur. Black, Indigenous, People of Color (BIPOC), and other underrepresented children, in particular, are less likely to receive needed mental health care and more likely to receive punitive consequences. Even when they do receive care, there is significant variation in the quality of care they receive compared to their peers. The effects of untreated mental health disorders are profound, including greater risk for poor academic outcomes, suicide, substance use, and unemployment in adulthood.