Teachers and school administrators should be knowledgeable about how mental health issues affect the overall learning experience of students with disabilities. Educators who can detect the early indicators of mental health concerns can help students access local resources and systems of support. The authors have highlighted the need for school-based mental health (SMH) to provide access to prevention and intervention and promote children’s positive and healthy development. Several recommendations for addressing mental health within a tiered support system are presented. Teachers are encouraged to build positive relationships and trust to support students with special needs, who may already be experiencing symptoms of depression and anxiety. The chapter concludes with suggestions to make these services easier and more efficient through administrative support, networking with community agencies, and capacity building.