This study examined if and how school counselors employ Telemental Health (TMH) to support students in crisis. Specifically, the researcher examined the barriers to using TMH in schools, what participants identified as effective and ineffective practices for using TMH in schools, and which synchronous and asynchronous TMH methods school counselors use. The researcher collected data via a Qualtrics survey wherein participants responded to open- and closed-ended questions. The data was analyzed using descriptive statistics and qualitative content analysis. The results include input from seventy-seven school counselors working in kindergarten through college counseling settings. The findings implied a varied comprehension and utilization of TMH within school settings to support students in crisis. All the school counseling participants' answers reflected the desire to help our students and the flexibility in approaches needed. The results highlighted the need to clarify TMH terminology, its practical implementation, and best practices for its utilization, and these clarifications should be the focus of educational initiatives aimed at current school counselors, school counseling students, and policymakers responsible for shaping the ethical and legal framework surrounding TMH applications in schools. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]