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The status of adolescent well-being is of concern, and high schools have responded by expanding mental health and social-emotional supports. However, there is little evidence-based research to support the ways in which educational leaders organize practices and policies in support of social-emotional well-being in high schools. Thus, this paper closes a research gap by presenting evidence from a multi-method, multiyear, national study on high school student social-emotional well-being. Findings include perspectives on the needs of high school students, how high school care needs vary from those of younger students, school-level supports that support care and social-emotional well-being, and equity-minded routines for care.