The COVID-19 pandemic has significantly impacted the mental health of children and families. This study sought to further explore the relationship between the pandemic (accounting for age and sex) and children's mental health outcomes, parenting quality, and service complexity. Data consisted of interRAI Child and Youth Mental Health Assessments from 5,067 children and youth between the age of 4-18-years-old. Surprisingly, our findings revealed the pandemic was not a significant predictor of parenting quality and children's mental health. Significantly lower levels of service complexity during the first few months of the pandemic were observed. Compared to younger males, older female children were more likely to experience internalizing symptoms and less likely to display externalizing symptoms. Older children (vs. younger children) were more likely to receive low parenting quality and experience service complexity. Clinical implications, limitations, and future directions are discussed.