The Targeted Mental Health in Schools (TaMHS) programme was a nationwide initiative that funded mental health provision in schools for pupils at risk of or already experiencing mental health problems. The implementation, impact and experience of this programme was evaluated using quantitative and qualitative methodology involving three main studies: (1) a 1-year RCT involving 8658 8-10 year olds and 6583 11-13 year olds, (2) a 3-year longitudinal study involving 3346 8-10 year olds and 2647 11-13 year olds and (3) qualitative interviews with 26 TaMHS workers, 31 school staff, 15 parents and 60 pupils. The RCT demonstrated that TaMHS led to reductions in behaviour problems but not emotional problems for 8-10 year olds. No impact was found for 11-13 year olds. The effects on behaviour problems in primary school were enhanced by the provision of evidence based self-help materials, but not by other area level support. The longitudinal study found information giving and good inter-agency working correlated with more positive outcomes for behavioural problems in secondary schools. The qualitative findings indicated that TaMHS was well received by all groups, though challenges to its implementation were noted. Overall, findings indicate the utility of targeted mental health provision in schools, particularly in primary settings. The implications for implementation are discussed.