Concerns about enhancing availability and access to mental health services in schools range from sparse resources to the proliferation of piecemeal and overspecialized interventions arising from categorical funding. This paper discusses such concerns and stresses that they must be addressed from a perspective that fully appreciates the degree to which school policies and practices marginalize student support programs and services. Changing all this is discussed in terms of reframing school reform to fully address barriers to student learning. Finally, a proactive agenda addressing the implications for new directions for pupil personnel professional is suggested. (Contains 40 references.) (Author/JDM)