This article provides a brief overview of the sociocultural and political factors in the U. S. that have influenced recent interest in school-based health and mental health programs. Four well-known programs are described as illustrative examples of the type of “first generation” mental health programs likely to be found in American schools today. A new framework is provided, the Tripartite Model of School-Based Mental Health Interventions, to stimulate future thinking on school-based programs and to help guide a second-generation of programs. These second-generation mental health programs will aspire to be maximally helpful, cost-effective, and widely used; utilize the full resources of the community and meet local needs; and offer an array of empirically validated prevention, treatment, maintenance, and health promotion services to children, youth, their families, and the school. Implications for emerging roles for school psychologists and priorities for training are addressed.