Across the United States, the number of children with mental health conditions has continued to rise. However, access and utilization of mental health services vary greatly. School-based mental health complements comprehensive school counseling and provides an opportunity for K–12 students to receive needed treatment they may not otherwise have access to. School counselors are well positioned to support the development, implementation, and sustainability of effective school-based mental health programming. We provide an overview of implementation science and case examples that detail the school counselor’s role in this work.