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Background: Art therapy is an emerging, evidence-supported mental health care service for children and adolescents, with a growing practice in education settings. However, the scope and nature of its implementation in Singapore remain uncertain. Aims: This study seeks to map the current art therapy practices and uncover the challenges faced by art therapists in Singapore's formal school system. Methods: Mixed methods, including an online survey and an in-depth focus group, were used. Results: Results suggest that school-based art therapy services in Singapore are still at an early developmental stage and not yet well-supported. Art therapists raised fundamental challenges including inappropriate physical space, poor scheduling, unsuitable group sizes, misaligned expectations with co-facilitators, insufficient ethical safeguard and complex relationships with other school stakeholders. Conclusion: Art therapy in Singapore's schools is in its early stage and considerable work is needed to advance theory, research, practice and policy. Implications for practice and policy: We offer actionable insights and call for urgent policy action to formally integrate art therapists into Singapore's education ecosystem and safeguard the mental health needs of our younger generation. Plain-language summary: Art therapy can be a powerful tool to help children and youths thrive socially, emotionally and creatively. While schools worldwide are increasingly using art therapy, many students in Singapore are missing out. This study offers insights into how art therapy is currently delivered in Singapore's schools. It demonstrates that school-based art therapy is still in its early stage of development and faces several barriers that make it difficult to deliver safe and effective programs. These challenges include unsuitable physical spaces, disrupted schedules, overly large group sizes, unclear roles between co-facilitators, limited ethical safeguards, and strained relationships between art therapists and school staff. Although there is growing appreciation for the potential of art therapy, the lack of institutional support and clear policies continue to limit its reach and impact. The study calls for policy action to formally integrate art therapy into Singapore's education system, ensure ethical and professional standards, and provide proper training and resources. With these steps, art therapy can become a sustainable and valuable support for students’ emotional, social and creative well-being in schools across Singapore.