Abstract
Over the last decade, an upward trend in the rates of youth self-injury, suicide, and violence towards others has caused growing concern. The global pandemic known as the coronavirus disease 2019 (COVID-19) has only heightened concern due to increased risk factors pertaining to stressors at the social, familial, economic, and health level, including major disruptions to typical routines and support systems. Unfortunately, there are many barriers for at-risk youth to access evidence-based mental health services. Such barriers include cost, lack of trained providers, lack of transportation, physical distancing due to the pandemic, and extended school closures. Providing school-based prevention and intervention programs that promote a positive school climate and student social, emotional, and behavioral well-being helps to address many of these barriers. This project highlights important considerations for providing these services in a school-based telehealth modality. Symptom clusters that put youth at-risk for harm to self or others are described. Best practice therapeutic modalities that can be disseminated in a school-based telehealth modality, such as cognitive behavior therapy, dialectical behavior therapy, mindfulness-based approaches, classroom-wide/school-based prevention curriculum, and postvention are reviewed. Although there is growing empirical literature for these school-based prevention and intervention approaches, additional research is needed to determine how to best support at-risk youth remotely via the school setting.