Background: Adolescents and young adults in low-and middle-income countries (LMICs), face multiple barriers to accessing quality mental health care, shaped by cultural expectations, systemic gaps, and widespread stigma. In Nigeria, little is known about how these factors intersect within psychiatric inpatient settings. This study explored the lived experiences of adolescents and young adults receiving inpatient psychiatric care to inform more culturally responsive, family-engaged, and psychologically supportive models of care. Methods: Using an Interpretative Phenomenological Approach, we conducted in-depth semi-structured interviews with 28 participants aged 13 to 28 years, all receiving care at a public psychiatric hospital in South-Eastern Nigeria. Participants were purposively sampled and represented a range of diagnostic categories. The hospital, serving a diverse catchment area, reflects a hybrid system of biomedical and traditional models of care. Interviews were conducted over nine months and analysed through iterative, reflexive engagement, supported by member checking to enhance credibility and contextual grounding. Results: Participants described a range of emotionally charged experiences, with stigma emerging as a major theme. Several reported social withdrawal, strained family dynamics, and shifts in how they were perceived by others. Relationships with peers in hospital varied, offering both connection and tension. Personal coping strategies, such as prayer, art, music, and peer dialogue were commonly described. Despite these efforts, many expressed a desire for consistent psychological support and greater engagement from staff. Hospital environments were viewed as both protective and limiting, with concerns raised about overcrowding, lack of privacy, and emotional neglect. Conclusion: While the findings cannot be generalised, they offer important insights into the mental health journeys of young people within a Nigerian inpatient setting. Participants called for greater emotional and relational support, staff communication, and culturally sensitive care. These perspectives highlight areas for further research and service improvement in youth mental health provision across similar contexts.