Background: This article reviews challenges to collaboration in school mental health (SMH) and presents practical strategies for overcoming them. Methods: The importance of collaboration to the success of SMH programs is reviewed, with a particular focus on collaboration between school- and community-employed professionals. Challenges to effective collaboration between school and community-employed professionals in SMH are considered. Strategies for overcoming challenges to effective collaboration are presented. Results: Marginalization of the SMH agenda, limited interdisciplinary teamwork, restricted coordination mechanisms, confidentiality concerns, and resource and funding issues are key challenges to collaboration. Strategies targeted toward each of these challenges may help improve the effectiveness of SMH programs and ultimately student outcomes. Conclusions: Collaboration between school- and community-employed professionals is critical to the success of SMH programs. Despite its promise, the success of SMH programs can be jeopardized by ineffective collaboration between school and community-employed professionals. Strategies to overcome marginalization, promote authentic interdisciplinary teamwork, build effective coordination mechanisms, protect student and family confidentiality, and promote policy change and resource enhancements should be addressed in SMH improvement planning.