In order to test the influence of therapist's ethnicity and language on the course of treatment for children and adolescents, this study investigated the effect of language and ethnic therapist–client match on the mental health treatment of thousands of Asian‐American, Mexican‐American, African‐American, and Caucasian‐American children and adolescents in the Los Angeles County Mental Health System. Conclusive support for the cultural responsiveness hypothesis for children was not found, but some validity for the hypothesis among adolescents was found. Ethnic match was a significant predictor of Mexican and Asian adolescent dropout after one session and total number of sessions, as well as African adolescent dropout after one session. When language match was added to the model for Mexican adolescents, language match was a significant predictor of dropout after one session and total number of sessions, whereas ethnic match was no longer a significant predictor. However, when language match was added to the model for Asian adolescents, language match was not a significant predictor of dropout after one session or total number of sessions, whereas ethnic match remained a significant predictor for both variables. Implications of these findings are discussed.

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Two hypotheses are typically invoked to examine the referral of adults into mental health care. The first is the clinical behavior hypothesis that suggests the psychiatric problem defines people as dangerous and risky. Accordingly, people with severe mental disorders are more likely to be coercively placed into mental health facilities. The second hypothesis suggests that people with less power are more likely than the powerful to be coercively placed in psychiatric care. We examine the extent to which these hypotheses are supported in a large urban community by investigating referrals into community mental health clinics that serve predominantly poor populations. The data set is unique because it includes four ethnic categories, whites, African Americans, Asian Americans, and Mexican Americans. The findings indicate that the clinical behavior hypothesis is applicable to whites and the stratification hypothesis is consistent with the data for African American, particularly African American men. The referral pattern for Mexican Americans and Asian Americans do not conform to the findings for whites and African Americans. It is likely that other sociocultural factors influence the referrals of these ethnic categories.