In this study, the Rennie Center for Education Research & Policy sought to uncover the ways in which Massachusetts schools and districts support students' behavioral health needs. This study was guided by the following research questions: (1) What are districts doing to integrate social, emotional and behavioral health supports? (2) What are the opportunities and challenges they face in doing this work? (3) What resources have districts relied on to reach desired levels of implementation? and (4) What student effects do districts report as a result of this work? To address these research questions, the study team conducted the following data collection activities: (1) Interviewed state education agency and school district representatives; (2) Scanned relevant Massachusetts policies to understand legislation and regulations related to behavioral health; and (3) Reviewed the literature base on tiered behavioral health supports in schools.