This article describes some key lessons from the MindMatters Plus (MM+) initiative, as a best practice approach to improving the mental health outcomes of secondary school students with high support mental health needs. The MindMatters Plus initiative focuses on early identification of students with mental health needs, implementation of preventative and other interventions, refining processes, policies and strategies to support students at risk, and encouraging the development of community partnerships to enhance the support of student wellbeing. Specifically, this article will examine the key factors that enabled the MindMatters Plus demonstration schools to achieve these outcomes. As part of the initiative, an interview was conducted with staff from each of the 17 MindMatters Plus demonstration schools. Staff members were asked to describe what they had learned as a result of their participation in the initiative and to identify factors that they believed were significant in their ability to improve the support they provided for students at risk. The responses to these interviews, as outlined in the present article, will serve as invaluable guidelines for other schools that want to improve the support they provide for students with high mental health needs.