Bernalillo County, New Mexico opened a mental health clinic to better address the needs of the juvenile justice population. This report examines how this County started by ensuring Medicaid eligibility for detained youth and then establishing a licensed free-standing community mental health clinic adjacent to its detention facility. Though costly and fraught with complexity, the clinic has proven a useful component in Bernalillo’s notable successes reducing detention populations and promoting success for court-involved youth. It offers a valuable case study for juvenile justice officials everywhere who are interested in improving mental health services for youth in their systems.