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Mental health and substance abuse issues disproportionately affect juvenile justice-involved adolescents. Yet, there is limited information on youths’ experiences before initial arrest. Understanding juveniles’ pathways is crucial for improving treatment access and reducing recidivism. Using semi-structured interviews with 24 juveniles adjudicated for aggravated offenses and administrators from secure youth detention facilities in one county in Texas, we analyzed the pathways juveniles take into the juvenile justice and mental health systems, exploring variations by racial and ethnic backgrounds. Administrative data and focus groups conducted with detention staff and service providers were used to better understand the challenges for juveniles.