BACKGROUND We summarize utilization patterns for mental health services in school‐based health centers. METHODS Administrative data on school‐based health center visits in New Haven, Connecticut were examined for the 2007‐2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were stratified by sex, ethnicity/race, and insurance status. RESULTS Mental health visits accounted for the highest proportion of visits (31.8%). The proportion of mental health visits was highest at 8 years (42.8%) and at 13 years (39.0%). The proportion of mental health visits among boys (38.4%) was higher than among girls (26.7%). Hispanic students had a lower proportion of mental health visits than black students (23.5% vs 35.8%) in all but 2 age groups. Students in the white/other ethnicity category had higher proportions of mental health visits than Hispanic and black students between ages 12 and 15. Students with no health insurance (22.5%) had lower proportions of mental health visits than students covered by Medicaid (34.3%) or private insurance (33.9%). The percentage of mental health visits by students with private insurance was highest (37.2%‐49%) in the 13‐15 age range. CONCLUSIONS Usage patterns for mental health issues show pronounced, nonrandom variation relative to age and other demographic characteristics especially with 8‐year‐old boys.