Mental illness is a major public health concern with significant social cost. Symptoms of mental health problems generally emerge during the school-age years. Although effective interventions are available to decelerate or eliminate incipient concerns, they are rarely accessible to youth. Evidence suggests that school-based mental health services (SBMHS) have the highest likelihood of reaching youth in need. In this paper, the authors and the Council for Children with Behavior Disorders present a foundation for future policy recommendations relative to the need for SBMHS and recommendations for implementation.