School mental health (MH) service use increased among adolescents in 2019, according to a research letter published in JAMA Pediatrics. Adam S. Wilk, PhD, and colleagues evaluated whether school MH service use increased among US adolescents aged 12-17 in 2019. The analysis included data from the National Survey on Drug Use and Health from 2009-2019 (165,686 adolescents). The unadjusted use of any school MH services increased from 13.8% in 2018 to 15.7% in 2019 (relative increase, 13.6%). In schools, use of MH services increased from 7.5% in 2018 to 8.9% in 2019 (relative increase, 18.1%). The odds of receiving any school MH services were greater in 2019 than each year from 2009 to 2018 (2019 vs 2018: OR, 1.13) in an adjusted analysis, with similar findings in schools only (2019 vs 2018: OR, 1.17). The 2019 increase was greatest among Black adolescents (2019 vs 2018: OR, 1.28) and adolescents with family income less than 100% of the federal poverty level (2019 vs 2018: OR, 1.32).