This thesis is an investigation of the needs and experiences of transition-aged youth with emotional and/or behavioural problems who accessed mental health services at a local child and adolescent clinic. Longitudinal studies have demonstrated that youth with mental health problems tend to have poor outcomes in adulthood. Moreover, many young adults do not make the transition from child- to adult-focused care even when they acknowledge their need for support. This study used a mixed methods approach, consisting of a survey design and phenomenological inquiry. In general, participants did not appear ready for an institutional transition, reporting only moderate levels of mental health self-efficacy. Youth disclosed their fears, underscoring the importance of supportive relationships, and stated the negative expectations they had concerning adult-focused care. The implementation of clinical supports to increase transition-aged youths’ mental health self-efficacy, by actively involving them in service-related decision-making processes, are likely to promote successful service transitions.