This manuscript presents the process and findings of a national quality improvement collaborative, the Mental Health Education and Training (MHET) initiative, designed to improve mental health service provision in school-based health centers (SBHCs), with an emphasis on enhancing collaboration between physical and mental health providers. MHET participants included multidisciplinary teams from 19 SBHCs in six states: Colorado, Louisiana, Michigan, New Jersey, North Carolina, and West Virginia. Findings demonstrate that the intensive learning collaborative model, with ongoing training, work-plan development, and continuous technical assistance, successfully changed provider behaviors in ways that reflect improvements in collaborative care between primary care and mental health providers. SBHC staff and providers reported enhanced collaborative care, and chart audits demonstrated that MHET sites made improvements in mental health service quality, including increased follow-up assessments and referrals upon the identification of students' mental health symptoms. Several strategies for improving collaborative care in school settings are discussed. © 2011 Springer Science + Business Media, LLC.