In this study we explored adolescent perceptions of what was most helpful and most challenging about mental health treatment for mood and/or anxiety disorders. Youth seeking treatment at the First Episode Mood and Anxiety Program were recruited to participate in a follow-up survey about their experiences of mental health care services. Responses to two open-ended questions were analyzed for emerging themes and differences between age groups and gender. Males were more likely to report therapy as being helpful than females, 16 – 18 year olds were more likely to report medication as a challenge to treatment, and 19 – 26 year olds were more likely to report accessing services as a challenge to treatment. Understanding what helps and what hinders treatment-seeking youth can guide both clinical treatment and service delivery models for this population.