Through school-based mental health (SBMH) care, children are more likely to access needed care in a natural and familiar environment. Results show that SBMH care improves student well-being, access to services, academic achievement, social emotional competence, prosocial behavior, and reduces internalizing and externalizing problem behaviors. A public health approach facilitates these outcomes through multitiered systems of support, community partnerships, and culturally, contextually responsive interventions. Lastly, an ecological lens can enable policy makers, program developers, and researchers in tailoring SBMH care programs according to need.