Research reports that young people aged 10 to 24 years are reluctant to seek help for a mental health problem due to multiple factors and that intervention within this demographic is critical. The aim of this review was to critique the existing literature, using a systematic approach on how the "type of helping relationship" affects young people's help-seeking behavior, engagement, and maintenance in mental health care. Searches of nine databases produced 22 relevant articles of original research with young people aged 10 to 24 years for inclusion in this review. A thematic analysis identified three themes: (1) "context of trust and confidentiality"; (2) "supportive rapport"; and (3) "collaborative approach to treatment." Findings indicate that researchers, practitioners, and policy makers need to prioritize the role of the helping relationship and its core components of trust and confidentiality, supportive rapport, and collaborative treatment, as essential in the provision of meaningful mental health care for young people.