Background Unaccompanied minors (UMs) are a population at risk for mental health problems, including post-traumatic stress disorder (PTSD). Yet, engagement with mental health services remains limited, with low utilization, missed appointments, and high drop-out rates, posing challenges to effective care. Purpose This study aimed to examine unaccompanied minors’ (UMs) mental health, their help-seeking behaviors, and their perceptions of and satisfaction with psychotherapeutic care, while exploring the links between PTSD symptoms and emotion regulation in a French department (Savoie). Method A total of 64 UMs who met a psychologist at least once completed self-reported questionnaires: help-seeking behaviors and therapeutic care, post-traumatic symptoms (IES-R), and difficulties in emotion regulation (DERS-F). Results Thirty-four percent of UMs exhibited probable PTSD. Greater PTSD intensity correlates with fewer adaptive emotion regulation strategies and lower emotional acceptance. After arriving in France, UMs significantly increased their reliance on formal medical services and mental health professionals (MHPs), while decreasing family communication and traditional medicine use. Despite few consultations, UMS reported high satisfaction with therapeutic care and the therapeutic relationship, suggesting trust in this new healthcare system. Conclusion Future research should explore the benefits of emotion regulation interventions for UMs’ mental health. Child welfare services (CWS) should prioritize strategies to improve therapy engagement and ensure sufficient MHP sessions, acknowledging cultural factors influencing their help-seeking behaviors.