Schools provide an ideal setting for early, accessible intervention according to research conducted in developed countries for adolescents experiencing adverse mental health (MH). Many schools in South Asia, however, lack structured and standardized school counselling services. Research indicates that where services do exist, students are reluctant to access them due to perceived high risks and low benefits in MH help seeking. This paper explores the challenges experienced in MH provision from the perspective of school counsellors. A qualitative approach was chosen, and three main themes emerged from the data using the thematic analysis: negative perceptions of MH and counselling, the unwillingness to invest in MH services, and the challenges inherent in the system itself. The findings reveal cultural implications behind these challenges and suggest grassroots level initiatives that can be implemented within schools to reduce the barriers to service provision without the need for legislative changes at a national level.