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.