Whenever safe and appropriate, youth with mental health needs should be prevented from entering the juvenile justice system. For youth who do enter the system, a first option should be to refer them to effective treatment within the community. For those few who require placement, it is important to ensure that they have access to effective services while in care to help them re-enter society successfully. There’s no denying that these outcomes come with practical challenges. But we know that reform is possible – with the right people collaborating to build systems that help communities improve the way they respond to youth with mental health needs. The aim of this paper is to encourage and support other communities to work toward similar reform for these youth.