AimIn many parts of the world, there is growing concern about youth homelessness. Homeless youth are particularly vulnerable to psychological distress, substance use and mental disorders, and premature mortality caused by suicide and drug overdose. However, their access to and use of mental health care is very limited.MethodsThe Réseau d'intervention de proximité auprès des jeunes (RIPAJ), a Montreal network of over 20 community stakeholders providing a wide array of cohesive services, was created to ease homeless youth's access to mental health and psychosocial services. Its philosophy is that there should be no “wrong door” or “wrong timing” for youth seeking help. In 2014, the network partnered with the pan‐Canadian transformational research initiative, ACCESS Esprits ouverts.ResultsCreated through this partnership, ACCESS Esprits ouverts RIPAJ has been promoting early identification through outreach activities targeting homeless youth and agencies that serve them. An ACCESS Clinician was hired to promote and rapidly respond to help‐seeking and referrals. By strengthening connections within RIPAJ and using system navigation, the site is working to facilitate youth's access to timely appropriate care and eliminate age‐based transitions between services. A notable feature of our program, that is not usually evident in homelessness services, has been the engagement of the youth in service planning and design and the encouragement of contact with families and/or friends.ConclusionChallenges remain including eliminating any remaining age‐related transitions of care between adolescent and adult services; and the sustainability of services transformation and network coordination. Nonetheless, this program serves as an example of an innovative, much‐needed, community‐oriented model for improving access to mental health care for homeless youth.

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In homeless youth, severe mental illness is an endemic and a serious issue that profoundly impacts this vulnerable population and warrants specific, comprehensive interventions. This chapter reviews the phenomenon, including the mutual interaction between youth homelessness and severe mental illness, its epidemiology, and its broad psychosocial associated factors. It describes the numerous barriers (such as those associated with homeless youth experiences and characteristics as well as social and health services organization) to mental health services related to suboptimal utilization of existing facilities and shortcomings in accessing them for homeless youth with severe mental illness. The chapter also describes factors facilitating access and summarizes efforts that have been made internationally to address these barriers through a rethinking of services organization and by implementation of specific interventions aimed at homeless youth and related populations with severe mental illnesses.