Background: School-based health centers (SBHC) can address unmet mental health needs. Little is known about how students seek care from different providers at SBHCs. We describe and compare how students' SBHC visits differ for students seen by mental health providers (MH group) relative to students seen only by primary care providers (PC group). Methods: Using administrative data with ICD-9 codes from 9 SBHCs in Denver, Colorado serving youth 10-19 years old during the 2014-2015 school year, we analyzed predictors of SBHC clinic visits via negative binomial regression and ICD-9 codes for first visit to MH providers. Results: Mental health users (N = 516) had an average of 14.2 ± 12.9 SBHC visits and PC users (N = 4026) had an average of 2.6 ± 2.4 SBHC visits annually. Students in the MH group, those with public insurance, and females had a higher incidence rate ratio for SBHC clinic visits than PC group students, those with private insurance, and males respectively. Depression was the most common primary diagnosis for the first MH visit. Conclusions: Students accessing MH services at SBHC return for follow up visits at higher rates than students only seeing PC providers. SBHCs represent a valuable opportunity to enhance integrated mental health services.