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New funding priorities of the National Institute of Mental Health have sponsored epidemiological studies that describe prevalence of most childhood and adolescent psychiatric disorders with much greater precision and reliability. Results of these show that a typical school of 1,000 students could be expected to have between 180 and 220 students with diagnosable psychiatric disorders. The most frequent of these are anxiety disorders and the behavioral disorders of conduct disorder, oppositional defiant disorder, and attention deficit disorder. In secondary school populations, depression and suicidal behaviors are also prevalent. Implications of these numbers for the practice of school mental health are discussed. The article concludes with an agenda for action at the school, district, and governmental levels that will include school psychologists in the decisions about ways to meet these very significant mental health …