This report from WestEd analyzes school-based mental health referral pathways that provide essential infrastructure for identifying and monitoring appropriate mental health services and referring students, families, and educators to those services. The Region 15 Comprehensive Center and Regional Educational Laboratory West collaborated with the California Department of Education and the California State Board of Education to conduct a landscape analysis of these pathways. The report aims to guide resource allocation and technical assistance to support student mental health services effectively. Key findings include: (1) significant mental health needs among students existed prior to the pandemic and have since increased; (2) there are critical shortages in behavioral and mental health staff; (3) mental health referral pathways lack alignment and coherence, with varied service delivery approaches; (4) limited funding flexibility and understanding of funding sources hinder service expansion; and (5) complex privacy laws and regulations are often poorly understood, posing a barrier to providing services.