In this qualitative study, 17 participants (N=17) currently practicing as school counselors and engaged in the provision of mental health services to student shared their perceptions in dealing with students with mental health and substance abuse disorder in a school setting. School counselors must provide responsive services to resolve direct and challenging experiences or difficulties for students in need of mental health support. This study is driven by the need to gain a better understanding of school counselors' perception of their role in servicing students with mental health or drug abuse issues. Questionnaire and interview data were gathered, coded, and analyzed. The emerging themes highlighted the challenges faced by the school counselor and the sources from which these challenges arose challenges. The structure of the school counselor's role often leads to them being assigned tasks that are outside their professional responsibilities, forced to cope with insufficient support systems and respond to a changing environment. The themes that emerged were related to professional development to cope with skill insufficiency, work overload, obstacles related to insufficient support systems and resources, improper role definition, and engagement challenges in practice. Limitations of this study include the small sample size and limitations of generalizability in qualitative research. The findings indicate that in order to effectively meet the needs of students, school counselors need robust, well-defined roles, resource and professional capacity to offer support. [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.]