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In public schools, students with the most severe mental health needs typically are receiving special education services under the federal label Emotional Disturbance (ED). Building upon the review conducted by Rones and Hoagwood (2000), the authors conducted a systematic literature review of school-based mental health services for students identified with ED. Results identified nine mental health related services that were both school-based and specific to this population of students. This review adds to the knowledge base regarding school based mental health services that have been identified as having a positive effect for students identified as ED. Implications of these findings, including advice for teachers who will be implementing these interventions, are discussed and suggestions for future research are presented.