The US Surgeon General's Report (1999) studied the prevalence of mental illness in school-aged children and adolescents. It concluded that the national prevalence rate of students with treatable mental health problems was 20%-25%. The report noted that an astounding 90% of children go undetected or undertreated in terms of their mental health needs. Schools, by their very nature, are ideal settings for primary prevention. They are structured to allow for professional observation of students' behaviors, over time, within a caring learning environment. School staff can be trained to observe signs and symptoms and refer them for professional diagnostic and treatment services when indicated. Three specialized programs demonstrate how timely observations and referrals for treatment by school professionals improve students' access to psychiatric care.