This mixed methods explanatory case study intends to explain low utilization of a joint initiative to improve language skills targeted to English as an additional language (EAL)/multilingual students (MLSs) in a disciplinary context. Considering the importance of discipline-specific language and literacy skills, a university health sciences faculty and an English language learning centre at a western Canadian University collaborated on a joint initiative to support EAL/MLSs. Language support services, such as an extra semester-long adjunct language tutorial, drop-in language services, and language support files uploaded on the Canvas Learning Management System (LMS) were provided for students enrolled in a first-year introductory-level health sciences course. A comparison of a pre-test and post-test Post-Entry Language Assessment (PELA) revealed improvements in both writing skills and perceived language skills. However, the discovery of the underutilization of language support services prompted a sequential explanatory mixed methods case study to identify learners' reasons for low participation. Findings from the quantitative survey and qualitative interviews are shared along with recommendations for improving language support service utilization.