Young adulthood (18–25 years old) is a period in which the onset of mental illnesses peaks. For young adults with serious mental illness and histories of adversity, access to appropriate, culturally sensitive care is critical. Religion and spirituality (RS) are interwoven into many individuals’ culture and are increasingly recognized as important constructs worth considering in the assessment and treatment of mental illness. This study examined data from a qualitative study of 55 young adults with serious mental illness who had used crisis emergency services to explore (a) how vulnerable young adults in psychiatric crisis talk about RS and (b) how religion/spirituality emerge in the narratives of their experiences, understanding and management of their mental health problems. Thirty-four of the 55 youth described RS organically within their interview. Across these interviews, four themes emerged: positive RS coping, negative RS coping, relationship with God, and implications for RS and mental health. Further, RS was described as a very complex topic for this sample, suggesting training is necessary for mental health care providers to appropriately assess and integrate this area of young adults’ lives. Implications and considerations for future studies are discussed.