Although it was started some ten years ago in Japan that psychiatrists should be involved as specialists in mental health activity in schools, what was expected at most was to give some therapeutic suggestions on inquiry by teachers in relation to desirable solutions to reduce problem behaviors as pathological symptoms. However, it is now beginning to be acknowledged by psychiatrists that they should not only help to reduce the already appearing severe symptoms, but also to maintain and even promote the mental health conditions of all school children and adolescents irrespective of whether symptoms are already present or not.
 The most useful activity for school teachers to be engaged in regarding both therapeutic and preventive mental health activities with certain positive results is to learn from case consultation in schools that they belong to with the attendance of psychiatrists about single symptoms after identifying them by themselves, and to know whether the single symptom really exists alone or is a component of a certain disorder, and also the cause of the symptom or the disorder. This activity is called "case consultation activity in school with the attendance of both a psychiatrist as a consultant and teachers as consultees".
 We are now proceeding to the next stage for the purpose of promoting cooperation in school mental health after nearly 30 years establishing a relationship with school teachers in Nishinomiya City, Japan. In the next stage of school mental health, we expect teachers to identify necessary and useful ways of cooperation with school children by themselves. We, as psychiatrists, can only help teachers proceed with this goal.
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