The U.S. children’s mental health system is faced with ameliorating the impacts of significant ethnic disparities in service utilization and outcomes. Furthermore, there has been little effort to assess the quality of children’s mental health care. In this study, we compare Haitian, African-American, and White caregiver perceptions of the quality of their child’s mental health care. Four overarching domains were examined: access to care, cultural and linguistic competence, engagement of caregivers, and appropriateness of services. Through the analysis, we identify ethnic differences in the experiences of caregivers in accessing and receiving services for their children, with minority caregivers reporting greater barriers and poorer quality of care. Structural and cultural factors are explored to understand the interaction of multiple processes that shape access to and quality of care. Implications for policy and practice are discussed, including the need for greater cultural competency and responsiveness in mental health care, and the need to build greater trust between providers and minority communities.