Studies have consistently documented that children in the foster care system are at a higher risk for psychopathology (Staudt, 2003). Although, studies indicate that children in the foster care system utilize mental health services at a higher rate than non-foster care children on public assistance (Halfon et al., 1992), not all children receive the mental health services they need and little is known about the utilization of services(Garland et al., 2000). In an effort to better understand mental health service utilization by children in foster care, studies have examined predictive variables of service use (Garland et al, 2000). These studies have most notably focused on the demographic characteristics of the child (Garland et al., 2000), but few studies have documented the referral patterns that foster care children take into mental health services (Martin et al., 1998). Understanding the referral patterns into mental health services by children in foster care can assist in identifying where the discrepancies exists between need, access, and service use. The purpose of this study was to examine what case characteristics predicted referral to mental health services by the court system and social worker, and whether case characteristics and referral lead to the utilization of services by children in foster care. The Los Angeles County Department of Children and Family Services was used to identify 185 closed court cases. Record abstraction was used to collect data from court reports. The sample consisted of school-aged children who had a closed court case between March 2004 and December 2004. A logistic regression (c2 (10, N=185) = 39.648, p=.00) indicates that older children, children who have experienced multiple types of abuse, and children who remain at home are more likely to be referred for mental health services by the court system. Social workers did not appear to favor any of the case characteristics when referring children to mental health services. When examining case characteristics, referral to mental health services, and mental health utilization, a logistic regression (c2 (11, N=185) = 38.164, p=.00) indicates that male children, older children, children who have been sexually abused, and children who are referred to mental health services are more likely to utilize mental health services. However, African American children are less likely to utilize mental health services. The referral and utilization of mental health services by children in foster care have practice and policy implications. Findings from this study suggest that the court system and social worker differ significantly in what influences the referral of children to mental health services. Policy needs to be developed so that all children in need of services are equally referred to mental health services by the court and child welfare systems. In addition, these findings also suggest that interventions need to be geared toward the specific case characteristics that are influential in the receipt of services and that the coordination between the mental health and child welfare systems needs to be established to provide services for those children who are referred to services.