Adult adoptees are at increased risk for mental health problems compared to nonadoptees. However, little is known about subsets of adoptees that may be more or less vulnerable to mental health problems. The purpose of this study was to explore the presence of mental health problems of American Indian (AI) persons compared to White persons who were separated from their birth families during childhood by foster care and/or adoption. Family systems theory guided the study. AI adoptees reported higher percentages of problems than White adoptees on all mental health problems measures (e.g., substance abuse, mental health, self-injury, and suicide). Data analysis included a series of chi-square statistics and logistic regression models. AI adoptees were more likely to report mental health problems, including alcohol addiction, alcohol recovery, drug recovery, self-assessed eating disorder, eating disorder diagnosis, self-harm, and suicidal ideation than were whites.