<p>Black adolescents are experiencing an increase in mental health concerns, including depression, anxiety, racial and traumatic stress, and suicide-related concerns amid the COVID-19 pandemic and racial unrest. However, many continue to face significant barriers to utilizing and accessing mental health support and services. This narrative review aimed to summarize existing mental health help-seeking and service utilization models, with the goals of analyzing their relevance, evidence, and fit among Black internalizing adolescents in need of mental health supports and services and providing recommendations for enhancing the models based on recent cultural, contextual, and generational shifts among Black adolescents and their families. The models reviewed included the Network Episode Model/Gateway Provider Model, the Behavioral Model of Families’ Use of Health Services, the Cultural and Contextual Help-Seeking Model, and the Theory of Planned Behavior. In all, there is a general lack of research on mental health help-seeking for Black adolescents with internalizing concerns, which posits the need for more research, including studies using advanced modeling analyses and longitudinal methodology. Further, considerations for updating the models include changes in the age of consent, digital mental health, COVID-19 post-quarantine, differences between youth and their caregivers, and structural-level interventions.</p>