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Objective: This study aimed to investigate the help-seeking behaviours among children and young people (CYP) from culturally and linguistically diverse (CALD) backgrounds for mental health (MH) needs in a multicultural Australian population. Methods: We analysed the electronic medical records (eMR) of 8135 MH-related emergency department (ED) encounters of CYP aged up to 18 years across six public hospitals in the South Western Sydney Local Health District, Australia, from January 2016 to April 2022. Urgency of MH care was grouped into high priority (triage categories 1 and 2, needing to have treatment within 10 minutes) and low-to-moderate (triage categories 3–5, needing to have treatment within 30–120 minutes) presentations. Multilevel logistic regression models adjusted for key covariates and patient level clustering examined the relationship between CALD status and urgency of MH care. We also assessed the combined effects of gender and CALD status, as well as CALD status and residential area socioeconomic status, on urgent ED care. Results: About 8.3% of all MH-related ED presentations during the 6-year period were classified as high priority. The odds of high-priority MH ED care were 2.03-fold higher for CALD CYPs compared to non-CALD CYPs (adjusted odds ratio (AOR): 2.03, 95% confidence interval [CI] = [1.46–2.82]). Furthermore, an added increase in the odds of seeking urgent MH care for CYPs who belong to multiple risk groups was observed among CALD male CYPs (AOR: 2.96, 95% CI = [1.81–4.85]) and those living in disadvantaged areas (AOR: 2.36, 95% CI = [1.59–3.49]). Conclusion: The findings of this study highlight the need for culturally appropriate services aimed at prevention and early intervention targeted at CYP from CALD backgrounds to avoid crisis presentations. [ABSTRACT FROM AUTHOR]