<p>Immigration-related discrimination is a unique stressor that many Latine youth and families face. Youth may experience discrimination from peers, teachers, adults in their communities, and health service providers. The ubiquitous nature of these experiences can influence how Latine youth engage with their healthcare providers, which may affect the therapeutic alliance and disclosure of suicide risk. We discuss the ethical and clinical considerations when working with undocumented youth and youth from mixed-status families who might minimize their mental health concerns as a means of preventing negative ramifications to their family. Using anti-racist frameworks, the authors provide recommendations for working sensitively and responsively with immigrant Latine youth and their families. Clinicians have a responsibility to protect vulnerable communities, manage personal biases, and increase their competence to provide quality services to immigrant families. Addressing the structural and cultural stressors are necessary steps to provide culturally responsive care.</p>