Concerns regarding levels of stress and increases in the prevalence of mental health issues have focused mainly on the general well-being of the teaching workforce. In contrast, this paper examines the issues around well-being potentially associated with the support of children whose distress may present as behaviour that challenges. In doing so, it critically explores whether the concept of 'compassion fatigue' originally emanating in health care provides a compelling explanation of the negative emotional consequences experienced by individuals, teams and schools, and its implications for how we approach sustaining well-being. The discussion concludes that the concept has utility and that its impact on individual teachers and whole school well-being is potentially significant.