Student mental health has received increased attention over the last years, with researchers and governments trying to identify the best ways to support students and adolescents (e.g., Johns Hopkins Bloomberg School of Public Health & United Nations Children's Fund, 2022). Efforts have concentrated on initiating mental health services and increasing school-and program-based mental health supports to address student needs at individual and school levels. Recently, some researchers have suggested teaching social-emotional skills within a prevention-focused school-wide tiered model because simply adopting a socio-emotional curriculum does not lead to adequate implementation or improved student outcomes (Greenberg et al., 2017). This chapter describes the mental health challenges at-risk students face and suggests strengthening their socio-emotional skills within the tiered continuum of supports of the School-wide Positive Behavioral Interventions and Supports framework.