This article addresses the fact that student-teacher relationships uncover many clinical issues, such as trauma. It looks at statistics of how prevalent mental health disorders and problems are and then shows that no teacher can handle all of the kinds of problems that will emerge in open relationships with the students. They need to do this work in the context of a productive student support team and system. The article provides a framework using the public health pyramid that can help organize schools. It ends by discussing the role of a consultant to teachers and the school to help with relationship binds, boundary transgressions, and dilemmas. (Contains 1 figure.)