This is a personal account of the transition from the child to the adult mental health services. The title references Janus, the Roman god of transitions. As such, the narrative looks to the past and the future in youth mental health. The discussion begins with a brief examination of the phenomenon of personal accounts in the broader context of evidence-based knowledge. There are a number of themes discussed throughout this perspective including access to education and loss of vocational capacity as a result of illness and service involvement. The discussion emphasises the importance of ‘Time’ in the delivery of services and provides justification for improved access to vocational and/or therapeutic options for young people with mental health difficulties. Time is also used as a structural device in order to communicate lived experience of mental illness, treatment and recovery.