Mental health problems among youth in the juvenile justice system are of particular concern given their high prevalence rate. The current study applies attribution theory and focal concerns to examine how mental health problems influence the judicial decision to commit youth to confinement. Furthermore, the study examines whether the effect of mental health problems is conditioned by race and ethnicity, hypothesizing that minorities with mental health problems will be treated more severely than Whites with mental health problems. Using administrative court records from Maricopa County, AZ (n = 5,501), findings reveal that mental health problems increased the likelihood of confinement, and this effect was moderated by race. Implications for theory and policy are discussed.