Background: Mental health conditions among youth are a major concern. Schools can play an important role in supporting students affected by these conditions. This study examined district-level school health policies related to mental health and social services to determine if they varied by district demographic characteristics. Methods: The School Health Policies and Practices Study (SHPPS) 2012 collected cross-sectional data on school health policies and practices from a nationally representative sample of public school districts (N = 684). We used logistic regression to examine the association between district-level demographic characteristics and school mental health policies. Results: Southern and low-affluence districts had higher odds of requiring schools to have a specified counselor-to-student ratio as compared with Northeastern and average affluence districts, respectively. Northeastern and urban districts had higher odds of requiring educational and credentialing requirements for school mental health or social services staff, compared to other regions and rural districts, respectively. Conclusions: Results describe the extent to which school mental health and social services programs in the United States are meeting various guidelines. More work is necessary to ensure that all schools have the resources needed to support their students' mental health and meet national guidelines, especially in districts with certain characteristics.