Background: Schools are in a unique position not only to identify mental health problems among children and adolescents but also to provide links to appropriate services. This article describes the characteristics of school mental health and social services in the United States, including state- and district-level policies and school practices. Methods: The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study (SHPPS) every 6 years. In 2006, computer-assisted telephone interviews or self-administered mail questionnaires were completed by state education agency personnel in all 50 states and the District of Columbia and among a nationally representative sample of school districts (n = 445). Computer-assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n = 873). Results: Although states and districts generally had not adopted policies stating that schools will have mental health and social services staff, 77.9% of schools had at least a part-time counselor who provided services to students. Fewer schools had school psychologists or social workers. Consequently, counseling services were more common in schools than were psychological or social services. Few schools delivered mental health and social services through school-based health centers. Arrangements with providers not located on school property were more common. Conclusions: SHPPS 2006 reveals that linkages with the community need to continue and grow to meet the mental health needs of students. Efforts must be made to build systematic state agendas for school-based mental health, emphasizing a shared responsibility among families, schools, and other community systems. (Contains 5 tables.)