Background: About 1 in 5 (20%) of Australian children and youth have a mental disorder over a 12-month period (Lawrence et al., 2015). Approximately 75% of mental disorders emerge before the age of 24 years (McGorry and Mei, 2018). Despite this, less than 30% of children and youth in need get evidence-based care. Research is needed to close the gap of poor service access, increasing emergency department (ED) presentations with suicidality and poor early interventions for mental disorders in the rural child and youth population. Objectives: To explore literature and evaluate new models of care in acute and primary care consultation–liaison (CL) psychiatry best suited to the mental health needs of children and youth in rural and remote Australia. Methodology: This is a series of three interrelated papers discussing (a) literature and application of an ecological approach to diverse rural microlevel mental health (MH) services; (b) literature review on telehealth-based acute, brief interventions and (c) qualitative participatory design of a collaborative telehealth primary care CL model in rural child and youth MH. Results: An ecological framework of the various barriers, facilitators and stakeholders in a chosen rural child and adolescent service will be presented. A scoping review of literature on Telehealth-based acute care services and a primary care CL model in rural child and adolescent MH services will be presented. Conclusion: There are gaps in service delivery in rural Australia. This gap can be due to geographical challenge, limitation with skills in primary care and timely accessibility to specialist services. Innovative, Telehealth-based responsive and culturally sensitive, trauma-informed models of care are critical.