This study drew on epidemiological data from a large urban school district to evaluate the implementation of a school-based mental health (SBMH) prevention initiative at 15 high schools. The purpose of this research was to measure the prevalence of student risk factors and protective factors by race and ethnicity and assess the engagement of Asian youth in prevention services. Results indicated statistically significant racial and ethnic group differences in the prevalence of risk factors (self-reported depressive symptoms, substance use, externalizing behavior at school, failing grades, truancy, and discrimination by school adults and peers), and protective factors (school, home, and peer assets). Controlling for gender, family structure, risk behaviors, protective factors, and school composition, Black (OR = 2.31, p < .001), Latino (OR = 1.36, p < .05), and multiracial (OR = 1.42, p < .01) students had significantly higher odds of using their SBMH program than Asian students. Among Asian ethnic subgroups, Cambodian youth (OR = .62, p < .01), were the only group that had lower odds of accessing school-based services than their Chinese peers. Findings suggest that, to reach underserved Asian American adolescents, prevention programs must address cultural and contextual influences on adolescent help seeking when program outreach and enrollment strategies are being developed. Additional research in the field of prevention science is needed to understand the mechanisms driving patterns of prevention service use by race and ethnicity.