The Telemedicine Wellness Intervention Triage and Referral (TWITR) Project leverages telemedicine services to intervene with junior high through high school students who are at risk for injury or harm to others or themselves in school settings. Students are identified and screened for risk-based behaviors in schools then provided psychiatric services by TTUHSC Psychiatry over a telemedicine link. Two telemedicine psychiatry sessions are provided through the project with students needing additional psychiatric services then incorporated into the TTUHSC Psychiatry Clinic. Response to intervention is measured in terms of changes in grades, truancy referrals, and discipline referrals in the schools. A 37 percent reduction in referrals has been seen for students receiving TWITR services.