Background: Children fluctuate in their risk for mental health-related problems. While children have demonstrated consistent trajectories for various types of mental health problems, the existence of developmental trajectories of overall risk of mental health problems has not been explored. This study aimed to identify distinct trajectories of overall mental health risk among children from ages 4–12 years. A secondary objective was to identify predictors of the mental health risk trajectories. Method: Data from the first five waves of the Longitudinal Study of Australian Children (LSAC) were used to assess mental health risk and potential predictors. The primary parent (n = 3717) completed questionnaires, time-use diaries, and face-to-face interviews over the five waves. Growth mixture modeling was used to identify distinct latent trajectories of mental health risk. Multinomial logistic regression was used to identify predictors of the trajectories. Results: Six distinct trajectories of mental health risk were identified: Low Difficulty (72.9%), Improvers (9.7%), Decliners (7.9%), Early Decliners/Late Improvers (4.7%), Early Improvers/Late Decliners (2.7%), and High Difficulty (2.2%). Child sex, sociability, parental warmth, sports participation, and household income were identified as significant predictors of mental health trajectories. Conclusions: There are distinct trajectories of overall risk for mental health problems during childhood. Research should focus on the High Difficulties group and the Early Improvers/Late Decliners group to address the predictors and improve access to early mental health services.