At least 20% of young people aged between 14 and 25 years who live in inland Australia experience a mental health or substance use problem at any given point in time. Many of these young people experience significant geographic, economic and sociocultural barriers to obtaining youth-friendly health advice and care, particularly in relation to key issues of mental health and drug and alcohol use. Only a small percentage ever receives care from health professionals. The use of schools to provide mental health and substance use education and care is explored as a possible means of overcoming these barriers and better addressing the needs of youth in rural and remote locations.