Given the prevalence of adolescent mental health issues and the impact they have on adolescent development and school success, school counselors are challenged to provide appropriate prevention and intervention services. Yet the sufficiency of school counselor training for these challenges is unclear. Qualitative procedures were used to examine eight secondary school counselors' preparation to recognize and respond to adolescent mental health issues. Results indicate beneficial aspects of training occurred prior to, during, and after their graduate counseling program. Training deficits and impediments were also identified. Implications for counselor educators, school counseling students, and school counseling supervisors are discussed.