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Objectives: 1) To describe activation skills of African American parents on behalf of their children with mental health needs. 2) To assess the association between parent activation skills and child mental health service use., Methods: Data obtained in 2010 and 2011 from African American parents in North Carolina raising a child with mental health needs (n = 325) were used to identify child mental health service use from a medical provider, counselor, therapist, or any of the above or if the child had ever been hospitalized. Logistic regression was used to model the association between parent activation and child mental health service use controlling for predisposing, enabling, and need characteristics of the family and child., Results: Mean parent activation was 65.5%. Over two-thirds (68%) of children had seen a medical provider, 45% had seen a therapist, and 36% had seen a counselor in the past year. A quarter (25%) had been hospitalized. A 10-unit increase in parent activation was associated with a 31% higher odds that a child had seen any outpatient provider for their mental health needs (odds ratio = 1.31, confidence interval = 1.03-1.67, p = 0.03). The association varied by type of provider. Parent activation was not associated with seeing a counselor or a therapist or with being hospitalized., Conclusion: African American families with activation skills are engaged and initiate child mental health service use. Findings provide a rationale for investing in the development and implementation of interventions that teach parent activation skills and facilitate their use by practices in order to help reduce disparities in child mental health service use., (Copyright © 2020 The Permanente Press. All rights reserved.)