Introduction: School-based mental health interventions constitute one of the most effective responses to the increasing prevalence of mental health problems among children and adolescents, demonstrating a positive impact globally. However, their implementation faces significant challenges related to the need to identify and adapt strategies to the school context in order to achieve the intended objectives.
Objective: This study aimed to explore the implementation strategies of a preventive school mental health intervention at the national level, incorporating the perspectives of the involved educational communities.
Methodology: A sequential exploratory mixed-methods design was employed. In the qualitative phase, a multiple-case study was conducted, with implementation teams as the units of analysis. Four cases were included, in which the following were carried out: (a) structured observations of school-based mental health prevention sessions (10 sessions per case; N = 40), and (b) semi-structured interviews with members of the implementation teams (n = 16). Data were analyzed using content analysis, which allowed for the identification and systematization of implementation strategies. Subsequently, in the quantitative phase, hierarchical cluster analysis was applied based on a consensus clustering matrix that integrated the qualitative findings.
Results: Fifteen implementation strategies were identified and organized into four clusters: (1) Diagnosis and Planning, (2) Training and Technical Support, (3) Collaboration and Networking, and (4) Implementation and Sustainability.
Discussion and Conclusions: The findings highlight that effective implementation requires not only technical training but also the consolidation of collaborative networks, the promotion of the well-being of school actors, and the development of sustainability mechanisms. In this regard, the proposed model—based on initial diagnosis, capacity building, alliance formation, and adaptive monitoring—constitutes a comprehensive framework that enhances the feasibility and impact of school mental health practices.