Ethiopia’s informal settlements are characterized by high levels of poverty and social dislocation, leading to significant mental health challenges among school-aged children. This ethnographic study employed participant observation, semi-structured interviews with educators and parents, and focus group discussions to understand the context and impact of existing interventions. The analysis revealed that while some schools had integrated mental health programmes, there was a significant variation in their implementation across different settlements, with certain areas showing higher engagement rates among children (72% vs. 45%). School-based mental health interventions can be effective in mitigating the impact of socio-economic adversity on child well-being in informal settings; however, there is a need for more consistent and tailored approaches. Educators and policymakers should prioritise the development of culturally sensitive and context-specific mental health programmes that are integrated into existing school curricula.