This study was conducted as part of a larger research project aimed at gaining a detailed understanding of rural elementary schools in disadvantaged areas and their environment to formulate recommendations for their development. This paper summarizes international and Hungarian literature that presents the work and methods of professionals working in small settlements, as well as programs targeting disadvantaged children and young people living there, with a particular focus on mental health and school inclusion. The target group belongs to the most vulnerable in society, as they have to face complex problems at a very early age. With this in mind, we have divided the study into two main sections. In the first part, we emphasize the power of community cooperation in and outside of school, presenting practices  on both national and international level. In the second section, we present a specific problem that strongly affects the target group, namely alcoholism and substance abuse, and its impact on children’s lives and mental health. The main conclusion of the study is that if we want to improve their living conditions, school performance, and mental health, we need complex, multi-professional cooperation and intervention as early as possible.