This phenomenological study sought to develop an understanding of school-based mental health programming through the shared experiences of elementary principals throughout the Commonwealth of Pennsylvania. More specifically, this study examined the programs, screenings, interventions, and personnel that support the mental health needs of elementary children, as well as the benefits and challenges of mental health support from the perspective of school leaders at the elementary level. Survey data was collected from 115 elementary principals across the Commonwealth of Pennsylvania. Additionally, 14 elementary principals from various geographical locations and community types participated in a semi-structured interview. The participants were selected based on their level of experience with mental health programming, as well as how mental health programming is prioritized at the schools they lead. All participants had either "some" or "extensive" experience with mental health programming and all participants placed a "medium" or "high" priority on mental health programming at their schools. The significant findings of this study include the role of social emotional learning competencies for all students, the utilization of specialized programs based upon available resources, the inconsistent implementation of universal screening tools, the importance of a team-based approach to identifying students in need, the critical role of school counselors in providing mental health support, the value of community-based partnerships, and the barriers to implementing school-based mental health programs. This study suggests school-based mental health programming has a positive influence on improving the overall school experience of elementary students. [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.]