Advocates 4 ALL Youth (ALLY) is a universal, 6-week mental health literacy program, implemented in schools during the school day by community volunteers. The aim of this study was to determine the efficacy of the ALLY program on youth who endorsed negative affect (i.e., self-reported symptoms of both depression and anxiety). Using a randomized controlled trial design, 5-6th grade students (11-13 years) attending three rural elementary schools in low-income and predominant African American communities were invited to participate. A total of 109 students (91% African American/Black) participated in the program (91% participation rate) and were randomized into treatment group--who received ALLY (n = 57) or control group (n = 52). All students completed a pre-post-assessment (baseline and post-program). A total of 58% youth in the treatment group endorsed negative affect at baseline and this was reduced to 53% post-program delivery (p < 0.01). No change in negative affect was reported in control group (44% pre and 44% post with self-reported negative affect). These results suggest that participants at greatest risk for mental health issues may benefit from ALLY.