It is estimated that 1 in 2 young people who are educated in Alternative Provision (AP) educational settings have social, emotional and mental health difficulties. However, the extent to which the mental health needs of these young people are currently being met by Child and Adolescent Mental Health Services (CAMHS) is less clear. In this qualitative study, semi-structured interviews were conducted with 15 CAMHS practitioners who had worked with young people educated in AP settings to explore secondary health care service engagement. We analysed the data using thematic analysis. Findings suggest that young people educated in AP settings have complex mental health needs for which they are currently not receiving adequate support, due to shortcomings within AP schools and numerous external barriers to care. Implications for clinicians and service commissioners include a need for further integration between CAMHS and education services, and better quality support across AP settings.