Purpose: Many children do not receive appropriate and timely mental health services. This paper reports a grounded-theory analysis of interviews with mothers who initiated mental health care for their children. Interviews addressed the pathways to care as well as the results of service use. Methods: This is part of a large mixed-method study of the mental health needs of women bringing their children for mental health care. 131 women who met criteria for current anxiety or depression were interviewed regarding their experiences with mental health care for themselves and for their children. Interviews were conducted three months after children presented for treatment. Interviews were selected at random until themes were developed, and no new themes were being added. Twenty interviews were randomly selected for this analysis. Results: Most mothers (17 out of 20, 85%) reported that their child had chronic, severe behavior problems, and had tried a variety of coping strategies before initiating formal mental health treatment for their child, strongly suggesting that most mothers in this sample considered formal mental health treatment a last resort. Although previous research has suggested that crises often precipitate treatment seeking, only four mothers (20%) reported a precipitating crisis. Six mothers (30%) reported that involvement with another agency (e.g., schools, or child welfare) led to this episode of treatment seeking. Mothers rarely reported that commonly-studied barriers (e.g., costs, waiting lists, or transportation) were the primary deterrents to seeking services. Instead, three themes emerged: (a) situations were too chaotic to organize a trip to the clinic; (b) mothers believed that something else would ameliorate child problems; (c) as problems increased, so did maternal coping. Of the 16 mothers who discussed treatment effectiveness, 10 (62%) reported that children improved or remained the same, and 6 (38%) reported that children were worse than when treatment began. Implications for practice and policy: Mothers' wishes to cope on their own or find other solutions to child behavior problems might be more important than commonly-studied pragmatic barriers. Mothers' beliefs in alternate treatments might be associated with stigma associated with mental health services. Overcoming stigma may help bridge the gap between families and needed services, as mothers might recognize that: (1) they are not alone; and (2) treatment tends to be more helpful than harmful. Practitioners should assess maternal distrust of mental health services and incorporate existing maternal coping strategies into treatment planning. Treatment development researchers may also benefit from understanding pathways to services, with an emphasis on the interaction between maternal depression and/or anxiety and perceived effectiveness of mental health services for their children. Policy implications include: (1) Identification of collaboration opportunities between mental health clinics and other community agencies to maximize access to needed services; and (2) Increase use of mobile outreach to bring services to families who are unable to bring themselves to services.