The emergence of Small Language Models (SLMs) as privacy-preserving alternatives for sensitive applications raises a fundamental question about their inherent understanding capabilities compared to Large Language Models (LLMs). This paper investigates the mental health understanding capabilities of current SLMs through systematic evaluation across diverse classification tasks. Employing zero-shot and few-shot learning paradigms, we benchmark their performance against established LLM baselines to elucidate their relative strengths and limitations in this critical domain. We assess five state-of-the-art SLMs (Phi-3, Phi-3.5, Qwen2.5, Llama-3.2, Gemma2) against three LLMs (GPT-4, FLAN-T5-XXL, Alpaca-7B) on six mental health understanding tasks. Our findings reveal that SLMs achieve mean performance within 2\% of LLMs on binary classification tasks (F1 scores of 0.64 vs 0.66 in zero-shot settings), demonstrating notable competence despite orders of magnitude fewer parameters. Both model categories experience similar degradation on multi-class severity tasks (a drop of over 30\%), suggesting that nuanced clinical understanding challenges transcend model scale. Few-shot prompting provides substantial improvements for SLMs (up to 14.6\%), while LLM gains are more variable. Our work highlights the potential of SLMs in mental health understanding, showing they can be effective privacy-preserving tools for analyzing sensitive online text data. In particular, their ability to quickly adapt and specialize with minimal data through few-shot learning positions them as promising candidates for scalable mental health screening tools.