Nationally, Aboriginal people experience high levels of psychological distress, primarily due to trauma from colonisation. In Victoria, Aboriginal Community Controlled Health Organisations (ACCHOs) provide many services to support mental health. The aim of the present study was to improve understanding about Victorian Aboriginal people and mental health service patterns. We located four mental health administrative datasets to analyse descriptively, including Practice Health Atlas, Alcohol and Other Drug Treatment Service (AODTS), Kids Helpline and Close The Gap Pharmaceutical Scheme data. A large proportion of the local Aboriginal population (70%) were regular ACCHO clients; of these, 21% had a mental health diagnosis and, of these, 23% had a Medicare Mental Health Care Plan (MHCP). There were higher rates of Medicare MHCP completion rates where general practitioners (GPs) had mental health training and the local Area Mental Health Service had a Koori Mental Health Liaison Officer. There was an over-representation of AODTS episodes, and referrals for these episodes were more likely to come through community, corrections and justice services than for non-Aboriginal people. Aboriginal episodes were less likely to have been referred by a GP or police and less likely to have been referrals to community-based or home-based treatment. There was an over-representation of Victorian Aboriginal calls to Kids Helpline, and these were frequently for suicide and self-harm reasons. We recommend primary care mental health programs include quality audits, GP training, non-pharmaceutical options and partnerships. Access to appropriate AODTS is needed, particularly given links to high incarcerations rates. To ensure access to mental health services, improved understanding of mental health service participation and outcomes, including suicide prevention services for young people, is needed.