In the literature on the behavioral health treatment needs of minority populations, very little attention is given to drug-using youth, ages 13 to 21, living in impoverished, ethnically diverse, rural regions. We propose a two-year multi-method ethnographic project to examine contextual influences on the drug use activities and the pathways to behavioral health care for Hispanic and White youth in southwestern New Mexico. The rural and economically depressed character of this region may intensify social, financial, and psychological stress experienced by drug-using youth and their social supports, and exacerbate behavioral health care needs. This proposed research would identify critical differences in needs, help-seeking processes, and determinants of service utilization for Hispanic and White rural youth. The study's overall goal is to provide formative research that will support the development of culturally relevant, quality care for rural youth. Our ethnographic approach combines semi-structured interviews, Photovoice methods, and focus groups. We will implement this approach among providers, drug-using youth, and their social supports in four rural southwestern New Mexico counties. Our approach will assess how (1) social supports, (2) community norms and values regarding drug use, (3) formal and informal treatment systems, and (4) broader social, policy, and regulatory contexts influence the experience of behavioral health problems and treatment-seeking in this rural area. Our three specific aims are: (1) to examine the ways in which behavioral health providers conceptualize (a) the diagnostic, treatment, and referral needs of Hispanic and White rural drug-using youth, and (b) the effect of social, regulatory, and policy contexts on drug use and treatment services for these youth; (2) to examine the ways in which Hispanic and White rural drug-using youth and their social supports conceptualize (a) drug use problems among local youth, (b) psychosocial and contextual influences on drug use, (c) appropriate treatment for drug use problems in formal and informal sectors of care, and (d) need for specific treatment resources; and (3) to examine the help-seeking processes of Hispanic and White rural drug-using youth and their social supports as the youth actively engage in treatment-seeking, documenting both barriers to care and strategies for overcoming impediments. This study will provide new data on drug use and treatment issues for rural youth in ethnically diverse settings, which are essential to designing effective public health prevention and intervention programs. This data will include information on sociocultural factors that influence how and why people of different ethnicities seek and complete treatment, in addition to richly detailed descriptions of how social supports, community contexts, and institutional dynamics are implicated in the help-seeking processes of rural youth. This study also will lay the groundwork for future community-based participatory research on youth drug use and behavioral health care in southwestern New Mexico.