This article examines the role of school support assistance in Germany from both a pedagogical and a child and adolescent psychiatric and psychotherapeutic perspective. It analyzes its conditions, potentials, and limitations based on legal and structural-systemic considerations. The findings indicate that school support services too often serve as a central prerequisite for attendance in mainstream schools, as they are frequently deployed when schools are unable to provide the structural conditions for inclusive education. As a result, the responsibility for ensuring educational participation is shifted from the institutional level of the school system to individually approved services within the child and youth welfare system. Coordination and delineation problems emerge at the interface of these two systems. These problems are further intensified by heterogeneous qualification levels and role conflicts and increase the risk of unintended exclusionary effects. Particularly for students experiencing psychological distress, school support assistance often assumes tasks that would require a continuous and professionally grounded integration of child and adolescent psychiatric and psychotherapeutic expertise in school-based support processes. This situation points to the need for a quantitatively and qualitatively stronger presence of relevant professional expertise in everyday school practice as well as for systematically coordinated cooperation with the therapeutic systems involved in treatment. From the perspective of child and adolescent psychiatry and psychotherapy, binding cooperation structures between schools, child and youth welfare services, and child and adolescent psychiatry and psychotherapy as well as clearly defined qualification standards and an increased emphasis on structurally oriented support models must therefore be developed and consistently implemented to secure inclusive education in a sustainable and participation-oriented manner.