Parents are gatekeepers for their children’s mental-health treatment, yet many are unclear about what behaviors warrant intervention. Seeking treatment is further complicated for immigrant parents whose cultural backgrounds may influence their understanding of mental health. This analysis uses qualitative data from [MASKED], which is a representative study of newly immigrated youth (12–18 years) and their parents, to examine parental perceptions of mental health and to determine patterns of help seeking and service use. Sixteen parents participated in semistructured qualitative interviews that used vignettes to elicit parental beliefs about adolescent behavior and mental health. Findings suggest parents 1) identify behavior that meets diagnostic criteria as problematic; 2) ascribe those behaviors to a range of etiologies; and 3) desire to intervene. Two areas of service delivery emerged as problematic: many parents expect services delivered in ways that conflict with current practice standards, and new immigrant families often encounter cultural and practical barriers to accessing care.