There is growing interest in the provision of health services that are sensitive to the needs of diverse ethnic groups. This paper examines ethnic diversity of attenders at a Child and Adolescent Psychiatric Clinic and how these groups differ in terms of referral route, reason for referral, psychiatric diagnosis and school report of difficulties. Service access relative to the distribution of the local population is assessed. Modification of OPCS categories provides additional useful information. The findings are relevant for the planning and provision of child and adolescent psychiatric services in a highly diverse population.