The purpose of this qualitative multiple-site case study was to investigate the self-perceived capacities of elementary principals regarding managing mental health problems demonstrated by elementary children. Further, this study sought to understand the complexity of the school principal's self-perceived role in addressing student mental health issues. This particular sample of principals all worked in Title I buildings, had no assistant principals, and had relatively little support staff resources to meet student needs. The main source of data collection was accomplished through multiple rounds of qualitative semi-structured interviews over a five-month period. Thematic analysis rooted in phenomenology and critical theory was utilized to understand and analyze the data. The results of this study provide insight and recommendations for pre-service administrator preparation programs and in-service administrator professional development to meet the needs of school principals who are required to effectively respond to students exhibiting mental health issues. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]