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Purpose: People with learning disabilities have complex challenges and needs that differ from people without these conditions. Accessing needed health and mental health care may be affected by level of independence and severity of learning challenges. Our study examined factors and associations which impact help seeking and satisfaction with mental health care in a Canadian nationally representative sample. Methods: Logistic regression and multinomial logistic regression was used to analyze the 2012 Canadian Community Health Survey- Mental Health (CCHS 2012) cross-sectional survey. We investigated the odds of distressed individuals (1) perceiving a need for mental health care, (2) seeking out professional mental health care, and (3) if their needs were met by mental health services. The presence of a learning disability was assessed as a moderator variable in all models. Results: Distressed adults with learning disabilities did not perceive a need for mental health care as often as distressed adults without a learning disability (OR = 3.82;95%CI:1.64,8.93 vs. OR = 12.00;95%CI:9.19,15.67). Distressed adults with a learning disability weren't as likely to seek out mental health services, but were more satisfied with the mental health care they received as compared to adults without a learning disability. Conclusion: The findings suggest that adults with learning disabilities have unmet needs. They are less likely to perceive a need for treatment, or to seek treatment, when they are distressed. Future investigation is necessary to understand the factors that influence perceived need and treatment seeking in this under-served population. [ABSTRACT FROM AUTHOR]