The purpose of this research was to understand how the needs of youth in mental health care contexts might be met through music-centered music therapy. This philosophical inquiry used Aigen’s (2005a) five dimensions of music-centered music therapy; the creative, expressive, aesthetic, communal, and transpersonal dimensions, to reason why this approach has clinical relevance with youth in mental health care contexts. Literature relating to music-centered music therapy, the needs of youth in mental health care contexts, and the use of music therapy with this population were explored in order to formulate a basis for the inquiry. The needs of youth in mental health care contexts were developed according to research on the needs of youth in general and the needs specific to youth in mental health care contexts. Needs relating to expressing emotion, understanding and formation of self, connectedness and belonging, feeling empowered, and coping with symptoms of mental illness were identified. Using the five dimensions of music centered music therapy as a lens to explore their interaction with the needs of youth in mental health care contexts, intersections and new insights were conceptualized. Lastly, the research findings, clinical implications, research implications and limitations are discussed. This research may be used as a resource for the use of music-centered music therapy with youth in mental health care contexts, and the emergent themes may serve as a starting point for additional research.