Emergency mental healthcare for young people in the UK has been described as fragmented, risk-driven and under-resourced. Drawing on insights from Australian service models, this editorial explores how timely, integrated and relational care can improve outcomes and reduce harm. Key innovations, including early intervention hubs, assertive aftercare, outreach models and telehealth, are examined through a realist lens to explain how and why they work. Recommendations are offered for rethinking the strategy and provision of youth crisis care in the UK, centred on developmental need, relational continuity and a departure from risk assessment tools that lack an evidence base.