Schools are increasingly recognized as a critical venue for the provision of comprehensive behavioral and mental health services for students. Unfortunately, difficulties associated with operating programs in schools often prevent evidence-based practices from being implemented and sustained as intended. In this study, the experiences of school and community providers who were funded through the Safe Schools/Healthy Students Initiative to implement mental health services in a large, urban school district were investigated using a qualitative focus group methodology. Providers identified the major challenges they encountered with implementing, operating, and sustaining their programs as well as the strategies that they used to overcome those challenges. Strategies to enhance support of school-based mental health programs are discussed.