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After the displacement of students following Hurricanes Katrina and Rita, schools in several states enrolled many students with potential mental health needs. This study sought to understand how schools perceived the mental health needs of these students and what mental health programs they implemented.Mental health personnel at 19 public schools or school systems and 11 private or parochial schools in Louisiana, Alabama, Texas, and Mississippi were interviewed at two time points (spring and fall-winter of 2006).Schools undertook diverse approaches to interventions, depending on the preexisting mental health infrastructure and personnel, the perceived needs of students, and the barriers or facilitators in each system. Interviewees described a rapid and comprehensive approach to the crisis in the immediate aftermath. Shortly afterward, some schools perceived little need for mental health services and refocused on their academic missions. Other school systems perceived student need but were unable to implement trauma-focused programs because staff were not prepared to deliver such services and funding was lacking. However, some systems and schools were able to implement new programs or extend programs to displaced students. Implementation challenges included difficulty communicating with parents, burnout among staff and program implementers, and efforts to balance the needs of the displaced students with those of the preexisting student population.Despite significant efforts to support students affected by the hurricanes, schools were limited in their ability to implement disaster-focused programs. Extension of crisis plans to include precrisis training in mental health programming for students and staff who have ongoing difficulties after a disaster or crisis may be beneficial.