This paper reports a mental health assessment of 60 homeless youth. Our study explored the mental health needs of youth accessing an overnight youth shelter. Participants completed an interview using one demographic form and one of two standardized questionnaires. Questions assessed youth mental health symptoms, examined various contacts that youth made with mainstream society (services, family), and identified potential motivating factors (hope, service satisfaction) that may play a role in fostering street survival during adolescence. Results: Forty-eight percent of the youth were clinically symptomatic and most youth accessed a range of general health services. However, those most in need had significantly less service satisfaction, less hope about the future, and had not accessed mental health services.