As the nation's schools seek to fulfill the academic imperatives of the federal No Child Left Behind Act and associated state imperatives, they may be forgetting an important missing element in boosting academic achievement: directly confronting the mental health and psychosocial needs that impede a significant percentage of children and adolescents. This article explores the available research on mental health services in schools and the theoretical basis for multiple approaches to the problem. Creating a comprehensive solution to address mental and behavioral barriers to learning could significantly improve academic performance in U.S. primary and secondary schools.