School Mental Health

Quality Guide
Screening

School Health Assessment

and Performance Evaluation System
School Mental Health Quality Guide: Screening is part of a collection of resources
developed by the National Center for School Mental Health (NCSMH) at the University
of Maryland School of Medicine. The Quality Guides provide information to help
school mental health systems advance the quality of their services and supports.
This guide contains background information on school mental health screening,
best practices, possible action steps, examples from the field, and resources.

Recommended Citation
National Center for School Mental Health (NCSMH, 2023). School Mental Health Quality Guide:
Screening. NCSMH, University of Maryland School of Medicine.

The mission of the National Center for School Mental Health (NCSMH) is to strengthen policies
and programs in school mental health to improve learning and promote success for America’s youth.

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What is School Mental Health
Screening?
School mental health screening involves the use of a systematic tool
or process to identify the strengths and needs of students. Screening is
conducted for all students, not just students identified as being at risk for or
already displaying mental health concerns. This might involve screening an
entire population, such as a school’s student body, or a smaller subset of a
population, such as a specific grade level.

Most commonly, mental health screening is used to identify individual

students who are experiencing or are at risk of experiencing social,
emotional, and/or behavioral difficulties. Screening can detect the onset of
challenges early so that they can be addressed before they escalate.

Screening measures can also ask students about:

• Indicators of well-being • Social determinants of mental health
and positive mental health • Adverse early life experiences
• School belonging • Food and housing insecurity
• Life satisfaction • Socioeconomic status

Why Screen?
1 Support a Multi-Tiered System of Supports (MTSS)
• Screening can help promote comprehensive school mental health strategies across all tiers.
As a result, appropriate supports can be provided to more than just those students who
present with the highest level of risk.

• With a multi-tiered approach, students are more likely to learn core social-emotional-
behavioral skills and may have their mental health needs addressed before they escalate.

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2 Identify students with high need
• Some school teams might screen to identify students who are in the most immediate need
of mental health supports.
• For example, students who endorse suicidal or homicidal ideation, engage in multiple risk-taking
behaviors, receive a certain number of office discipline referrals, and/or experience poor academic
progress.

• As part of the screening process, screening teams must ensure that referrals to school and
community mental health services are provided in a timely manner and that any student
who may be a danger to self or others is further assessed immediately to ensure safety.

3 Identify concerns specific to certain grades or classrooms

• Screening data can also shed light on strengths and concerns specific to certain subsets of
a school’s population, such as a single grade or age group. Understanding these possible
trends can be critical for providing equitable supports within a school.
• For example, a schoolwide screening effort may reveal that several classrooms may have a significant
number of students with more intensive social-emotional-behavioral needs. Rather than take the
time to individually follow-up with every student, it may be helpful to provide classroom supports
and then assess if there are larger group dynamics and classroom factors that may be contributing
to the increased number of students with higher level needs.

• Screening data can help prioritize which students may benefit from more individualized
services versus those who can have their needs addressed as part of a broader classroom
or small group intervention.

4 Inform promotion and prevention strategies

• About 20% of students show signs and symptoms of a mental health disorder in a given
year. Mental health screening is a proactive approach to gathering valuable information for
planning and implementing prevention and early intervention strategies for the other 80%
before problems develop or worsen.

• When schools systematically ask students about indicators of well-being and social-
emotional distress, they gather information that enables them to implement targeted
prevention and early intervention strategies that can address the unique needs of a school
or community.

• For example, if screening reveals high levels of student stress and anxiety, teaching coping skills
to help reduce anxiety may be a helpful strategy to implement in classrooms.

• Screening with follow-up support can also detect and address student mental health
problems early before they escalate.

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5 Assess indicators of positive well-being
• Mounting evidence suggests that asking students about their well-being and social-
emotional strengths, in addition to their psychological distress and functioning, has several
benefits, including:
• Reducing stigma around asking youth about mental health within the school setting
• Enhancing students’ sense of empowerment and self-esteem
• Providing valuable information about all students
• Adapting to varied perspectives on mental health from youth and families across cultural groups

• Research suggests that students who experience average to high levels of well-being also
experience better current and long-term outcomes, including academic success, compared
to students who report low levels of well-being. These findings remain true regardless of
level of psychological distress and impairment reported by students. Thus, screening for
complete mental health, including both strengths and symptoms, may be warranted.

6 Improve access to mental health services and supports

• Only a fraction of children, adolescents, and families who experience mental health concerns
access outpatient care in traditional, community mental health settings, and of those that
access care, about 40-60% drop out of treatment early.
• These rates speak to the barriers that keep many families, especially ethnoracially minoritized
families and those from low socioeconomic backgrounds, from accessing mental health care.
Many of these barriers can be avoided by identifying and supporting students in school.
• It is estimated that over 70% of all mental health services received by youth in the United
States are provided within schools. Children and adolescents are much more likely to initiate
and continue mental health care in school than in other community settings, including
community mental health centers.
• Several barriers, including stigma, transportation, and financing, contribute to the high no-show
rates for mental health services in the community. Identifying and addressing student mental
health concerns at school improves access to mental healthcare for all students, including
traditionally underserved youth.
• The provision of mental health supports and services in school positively impacts student
outcomes including improved academic performance, fewer special education referrals,
decreased need for restrictive placements, fewer disciplinary actions, increased student
engagement and feelings of connectedness to school, and higher graduation rates.

7 Support economically sound outcomes

• Early identification of social, emotional, and behavioral difficulties and early intervention
services are less costly than long-term, intensive mental health care options such as
emergency department care and inpatient hospitalization.
• Universal school screening has been shown to connect students and families to cost-
effective services such as individual and group outpatient mental health services and
support groups.
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 UALI
1 Plan and implement mental health
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screening

Best Practices
• Include students and families in informing the screening, planning, and
implementation process.
• Identify a culturally relevant screening tool or process (e.g., normed with population,
measures indicators valued by population) that considers reliability, feasibility, cost, and
fit with the goals for screening.
• Select a tool or process that assesses student social and emotional strengths as well as
risk for mental health concerns (including exposure to trauma).
• Consider screening tools that assess social determinants of health and education
(e.g., racism, poverty, social injustice, food insecurity).
• Share information about screening in multiple formats prior to implementation, with
consideration for diverse cultures and languages.
• Engage students and families in a consent process about screening procedures in
advance of implementation and offer the opportunity to consent or opt-out.
• Support families’ understanding and decision making about the screening procedures.
• Ensure there is an updated list of internal and external mental health resources to
support students/families screened for specific concerns/needs, including poverty,
food insecurity, and trauma-specific services.

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Tip: Start small

Starting in small increments may be helpful to districts and schools as they embark on
the screening process, allowing them to make course corrections as needed.
• For example, many school district leaders have pointed to the usefulness of
trying out a screener with a few students and getting feedback or starting with
a classroom or grade and then adjusting the process rather than starting the
screening process with an entire school or district.

Resources
The Trauma ScreenTIME Courses help schools, primary care, child welfare, juvenile justice,
and early childhood systems by:
• Improving the early identification of children experiencing traumatic stress.

• Providing strategies for talking with and supporting children impacted by

trauma and their families.
• Connecting children to evidence-based treatment and other services when
needed.
ScreenTIME Schools Course is appropriate for staff in school settings including
teachers, school administrators, school mental health staff, school physical health staff,
and office staff.

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 Action Steps for Developing a
School Mental Health Screening Plan *

1. 2. 3.
Build a Identify
Clarify Goals Resources &
Foundation
Logistics

4. 5. 6.
Select an Determine Develop Data
Appropriate Consent & Collection
Screening Assent Processes
Tool Processes

7. 8. 9.
Develop Develop Address
Administration Follow-Up Barriers
Processes Processes

* Each action step is described in detail on the following pages

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Action Step 1: Build a Foundation
Assemble a Team: School mental health screening should be planned and implemented by a
core screening team including:
• School administrators and staff
• It is imperative that school staff with knowledge and training in mental health are identified
for leadership positions on the school mental health screening team. Specifically, leadership
roles should be held by school staff members who are competent in identifying mental health
symptomatology, conducting assessment, and implementing intervention. In most cases, a
school psychologist or school mental health clinician should take on the leadership role or divide
the role according to given grade levels.
• Community, students, and families
• Community members or staff from child-serving organizations, students, and families can be
key leaders throughout the screening process. Including school-based community providers
and other community leaders from mental health and business organizations broadens the
knowledge, experience, and perspectives gained by the team.
• School screening teams must consider how to communicate with students and family
members in a culturally responsive way throughout the screening process, from garnering
input to providing results and referrals for follow-up. Including students and family members in
the process can help ensure cultural relevance for students and increased buy-in from parents
and guardians.
• Community members such as interpreters, clergy, and community program staff can also be
important for consultation and referral to programs that may be more accessible and acceptable
to students and families.

Tip It is not always necessary to create a whole new team for

screening. Here are some questions to ask when deciding who
will work on the effort:
• What teams or groups are already working on something related to
health/mental health that can be expanded?
• How does your school screen for academic performance? Are there
people or processes that could be included in mental health screening?
• Who (staff, family, community members) has expressed interest in mental
health, collecting and analyzing data, or systems-level change? Can they
lead or be involved?

Resources
• The School Mental Health Team Roles and Functions Template can help teams map
the roles of each team member.
• Nine Elements of Effective School Community Partnerships to Address Student
Mental Health, Physical Health, and Overall Wellness provides guidance on forming
school-community partnerships.
• Hanover Research’s Best Practices in Engaging Diverse Families reviews literature and
case studies on engaging familes from diverse backgrounds in K–12 school settings.

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Tip The screening team needs to ensure all the following processes are

addressed and guided by appropriate leadership and staff:
1. Plan the screening process.
2. Administer screening measures, including administering and
interpreting other languages as needed.
3. Score surveys and identify any students at imminent risk.
4. Coordinate follow-up supports, as needed.

Action Step 1: Build a Foundation (continued)

Generate Engagement and Support
• Getting engagement and support is critical to the success of a new screening process.
However, engagement and support should be solicited throughout the screening process,
not just at the beginning.
• Input can be obtained in many ways, including:
• Focus groups of key stakeholders that represent diverse identities and backgrounds. Possible
topics to address could include perceptions of benefits and challenges of screening, and/or
consent and privacy considerations.
• Teams can also add screening as an agenda item at staff and family meetings or collect anonymous
student and family feedback cards distributed in class, in the office, or by mail.

Gather Strategize Consider Devise

Gather input using Strategize how goals Consider how Devise a strategy to
several methods, fit with other district students are currently communicate the
such as focus groups, initiatives. being identified for need and rationale
parent/staff meetings, MH services and the for the school/district.
and feedback cards. implications for
service provision.

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Action Step 1: Build a Foundation (continued)
Cultural Considerations
• It is important to understand cultural values and unique considerations of different
communities and subgroups of students when implementing school mental health screening
and supports. Consider:
• Complex stress related to poverty, immigration, and language barriers
• Cultural beliefs about mental health and how concerns should be addressed
• Historically marginalized and underserved groups
• Strengths-based screenings, which may be more acceptable across cultural groups

Use Data
• Data can support justification for mental health screening.
• For example, one district used data from their screening pilot to demonstrate the value
of screening:
• Students who scored in the moderate to severe range for depression are absent 47% more often
than the average for students.
• GPA was consistently lower for students who scored in the moderate to severe range on two
different mental health screeners.

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Action Step 2: Clarify Goals
It is imperative to clarify the goals of screening prior to selecting screening tools or
communicating to those outside of the screening team about upcoming screening
administration. For example:
• Screen all 6th grade students in one district for anxiety to inform who may benefit from
additional support during the transition to middle school.
• Screen all 9th grade students in one high school for depression, including suicidal
thoughts, to improve identification of students for counseling and inform schoolwide
suicide prevention efforts.
• Screen all students in one district for school connectedness to identify which schools have
higher rates of school connectedness and learn from their efforts to improve connectedness
in other schools.

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Action Step 3: Identify Resources & Logistics
Staffing
• It is advantageous for screening teams to collaborate with school staff and community
providers to support screening at different stages of the process.
Below is an example of how one team divided their tasks:

Establish plan for obtaining buy-in from

District Leaders &
students, families, staff, and community
School Administrators
partners

Teachers & Paraprofessionals Classroom administration of screeners

Student Instructional Support Assist with obtaining buy-in from

Personnel non-MH staff; administer screeners;
(e.g., School Psychologists, immediate follow-up; accept new
Social Workers, Counselors) referrals; provide services

Administer screeners; accept new

School Health Center Staff referrals; provide services; immediate
follow-up

Community Mental Health Accept new referrals; provide services

Providers

Data Infrastructure
• Screening teams may find it helpful to integrate data from screening into existing data systems.
• Several online platforms for behavior management exist, as well as Student Information Systems (SIS)
used to track academic and behavioral data.
• When considering using an existing SIS, screening teams must consider if they have the proper
consents that explain how the data would be stored, who would have access, and how it would
be used to include it in the data system.
• Data can also be collected using an electronic survey administration.

Resource
The Student Information
Systems (SIS) Brief
highlights benefits of
using an SIS, and offers
a comparison of several
available SISs.

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 Action Step 4: Select an Appropriate Screening Tool

Is it reliable, Is it free or can How long Does it come Does it screen for
valid, & it be purchased does it take with ready access what we want to
evidence- for a reasonable to administer to training & know? (e.g., type of
based? cost? & score? technical support mental health risk,
for staff? positive mental health
& well-being, age range)

Consider Other Indicators of Students’ Mental Health

• As part of the measure selection process, it is beneficial to think beyond just measures that
focus on mental health symptoms to include measures that consider social determinants of
health and indicators of academic success, well-being, and distress. Inclusion of these factors
can help to prioritize which students are in most need of additional supports.
Examples might include:
• Grades • Indicators of students’ socioeconomic status (e.g., parents’
• Attendance highest level of education or free/reduced lunch status)
• Office discipline referrals • Social determinants of mental health (e.g., food or housing
• Engagement in substance use insecurity)

Resource: The SHAPE System Screening and Assessment Library

The School Health Assessment and Performance Evaluation (SHAPE) System, a free
online platform for district and school teams, includes screening tools appropriate for
use in school mental health. Search for the screening or assessment tool that best fits the
needs of your school by focus area (academic, school climate, or social/emotional/behavioral),
purpose, student age, language, reporter, and cost. Every measure has been carefully
reviewed and includes a brief summary with direct links to copies of the instrument and
scoring information.

Tip Use validated, culturally responsive screening measures that reflect

valued outcomes, are appropriate (e.g., developmentally) to student
population, and are in the first language of students and families.
• Also, it is critical to use tools and methods of administration that are sensitive
to students exposed to trauma. This includes creating a safe environment for
screener administration and communicating about the purpose and process
of screening in a transparent manner.
• The Screening Team should get feedback from youth, families, and other
stakeholders to ensure that the screening tools are culturally responsive,
easy to use, and that the items themselves make sense and are relevant
for students across diverse identities and backgrounds.

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Action Step 5: Determine Consent & Assent Processes
Active vs. Passive Consent: An important decision when planning consent procedures is the type
of consent, active or passive/opt-out, sought from students’ parents and legal guardians.

Definition Strengths Limitations

• Engages less diverse
• Consent is informed
distribution of students;
• A student may only • Follows many district better for engaging
Active participate in screening protocols students such as those
Consent if their parent/guardian from two-parent homes,
• May establish more
gives written consent with high grades, and
trust between schools
involved in extra-
and families
curriculars

Passive/ • Parent/guardian’s
• Follow-up screening
non-response serves as • Reaches largest number
Opt-Out consent for student of students
efforts require active
Consent consent
screening

Passive Consent/Opt-Out Example

Dear Parent or Guardian,

To promote the health and well-being of students in [X]

Public Schools, students will be periodically provided
with questionnaires, surveys, and screeners that address
issues related to mental health. The information gained
will support the school’s ability to provide comprehensive
and timely support for your child if they require any
assistance.
Students can opt out of filling out any questionnaire,
survey, or screener that they are not interested in taking
and parents/caregivers can opt-out their child at any time
by contacting the Guidance Office of your child’s school
or filling out the opt out form [here].
A list of the questionnaires, surveys, and screeners is
available below for you to review. We are committed to
ensuring your student is supported academically, socially,
and emotionally, and we look forward to partnering with
each of you toward achieving this goal.
Please contact [X] at [X] with any questions.

In partnership,
[School or District Administrator]
Passive consent may be sent via mail
to parents and included in the school
handbook/website. Information
provided may include the purpose of
screening, the content of the screening
tools, and instructions on how to opt-out.

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 Tip State laws or district policies may affect the ability to conduct

active versus passive consent.
As the screening team decides on consent procedures for their school(s), they
must have thorough knowledge of school and district policy and procedures
related to asking about and handling information about students’ mental health.
If working in partnership with an outside entity such as an agency, organization,
hospital, or university, it may also be necessary for these entities to have
consent procedures approved by their Institutional Review Board (IRB).

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Action Step 5: Determine Consent & Assent Processes
(continued)
Student assent
• It is recommended that screening teams gain students’ voluntary assent for participation in
screening. Often, this is done at the beginning of administration and an option is provided
for students to indicate:
• “Yes, I will take this survey” or
• “No, I choose not to take this survey”
• It should be made clear to students that there are no disciplinary or academic
consequences for choosing not to participate.

Communication
• By providing a consistent message on the purpose and importance of screening to students,
families, and staff, schools improve their likelihood of having higher rates of consent and
assent. To reach the largest number of students and families, communication of this message
should be done in multiple formats, including:
• Phone calls and/or text messages • Forms/information sheets included as
• School website part of yearly registration packets
• Written notification in the mail • Discussions with students in class and
• Fliers sent home with students parents/caregivers at meetings
• Signs displayed around the school

Cultural considerations with consent procedures

• Students and families from cultural backgrounds other than the majority group might
experience distrust and fear about the screening system. Therefore, communication
facilitated by cultural liaisons and brokers, as well as translators for written consent forms,
can be critical in obtaining buy-in and ensuring that the purpose of screening is
understood by all families in the school.
• All team members, including translators and cultural liaisons, should be easily reachable by
meeting, phone, or email once consent forms have been provided to families.
• Having someone readily available who can help families to read consent forms aloud,
answer questions in preferred languages, and provide needed assurance about screening
can greatly increase the likelihood of caregivers providing consent for their child to be a
part of the screening process.

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Action Step 6: Develop Data Collection Processes
Data Management and Privacy
• Consider data management and privacy as it relates to FERPA and HIPAA
• Decisions about how data are managed also depend on district guidelines, as well as federal
guidelines for maintaining student and family records within schools and as part a student’s
healthcare (i.e., Federal Educational Rights and Privacy Act [FERPA] and Health Insurance Portability
and Accountability Act [HIPAA]). School leadership needs to decide where data will be stored, who
will have access, and how the data will be used. Appropriate consents and releases of information
must abide by respective guidelines and procedures that have been established.

• Online platform vs. Paper and Pencil

• Increasingly, school screening teams are choosing to administer measures through online
platforms (e.g., Qualtrics, SurveyMonkey, Google Forms) instead of paper and pencil. Online
administration may allow for students and families to easily switch between languages to answer
items. If choosing online administration, the screening team must confirm that chosen screening
tools can be converted to an online format per the author/publisher policy.
• Paper and pencil can be useful because it allows all students in a school to complete the survey
at once and doesn’t require all students to have access to computers or other online technology.
However, paper and pencil administration requires manual entry of all responses, which can
be time-consuming for members of the screening team and increase the likelihood of errors in
scoring and data entry. Additionally, there is potential for a delay in being able to review surveys
for responses indicative of a need for a mental health referral and/or to address more pressing
safety concerns.
• For both online and paper and pencil administration, it is essential that the responses be
reviewed within 24 hours for any pressing concerns. A review should not require that all entries
first be inputted into a data system related to the potential time sensitivity and safety
implications of the information. (This is most relevant when administering measures that inquire
about potential harm to self or others or other serious mental health concerns that would require
immediate attention.)

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Action Step 7: Develop Administration Processes
Who to screen? When to screen?
• The screening team may consider a • Consider using times of day outside of instructional
small pilot administration in the time. A common recommendation from the screening
months leading up to the actual literature is to conduct administration during students’
administration in order to trouble- homeroom period, if possible.
shoot any difficulties and to gather • Screening team leadership should consult with teachers
feedback on the effectiveness of and administrators about optimal periods of the day to
screening processes. screen, ensuring that teachers have also been informed
• Piloting can include administration about the purpose and importance of screening.
with a small number of students in • If administering screening through an online platform, it
one grade or classroom. may be beneficial to schedule classrooms to complete
the survey during the first 15-25 minutes of their
• After a pilot, the team will consider resource period. This will allow for class schedules to
whether it is feasible to screen a proceed as usual.
broader group of students.
• It is important to ensure that all students who should be
screened are included in the time period or class subject
selected (e.g., some older students may leave school early
for work study).

Staff to support screening Scripts

• All school staff involved in • Screening proctors are typically teachers, para-
administration and follow-up should professionals, counselors, school psychologists, or
receive clear written and oral school social workers. Some school districts also partner
communication about: with community mental health providers or university
• When the screening will take place mental health graduate programs to assist with
screening administration.
• Who is responsible for distributing • Prior to screening, proctors should be provided a script
surveys (via paper, desktop/laptop,
to read to students at the beginning of administration.
tablet, or other device)
This ensures that the screening process is standardized.
• Who is responsible for proctoring Scripts should also be translated into other languages
during the screening periods spoken at the school, with staff members or cultural
liaisons present to read and respond to any questions
• How to handle students who are related to the scripts.
late for or miss initial screening
administrations • Content in the script should include:
• Introduction to the screening process: purpose of
• How to identify students who screening, confidentiality of results, and relevance
declined consent to students
• Where to return completed • Step-by-step instructions for completion
surveys (if paper and pencil)
• Guidelines for returning surveys to the appropriate
location (if applicable)

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Action Step 8: Develop Follow-Up Processes
Tiered approach to follow-up
• Literature on screening recommends that interventions be implemented at the universal,
targeted, and intensive levels within a MTSS framework.
• A resource map of school and community resources can help identify supports and services
to be implemented for students at different levels of risk.

Follow-up schedule
• Efforts to follow-up with students who might need additional supports should occur as
soon as possible. When students have a positive screen, they will be referred for further
assessment to better understand specific strengths and challenges. Recommendations for
efficient and responsive follow up are as follows:
• High risk: Same day
• Moderate risk: Within the week
• Low risk: Communicate findings to staff, students, and parents within a reasonable
timeframe (e.g., one month)
• Follow-up should include procedures to follow-up with caregivers and school staff.

Community partnerships for follow-up and referrals

• Once school-community partnerships are established, it is important that screening
teams alert crisis teams and local community mental health providers to be on call before
screening administration. This can help to ensure that local organizations and providers
are prepared and adequately staffed so that students and families can access supports as
needed in a timely manner.

Trauma-informed and culturally responsive follow-up

Identify
opportunities
Individualized
Incorporate to enhance
follow-up
multiple education on
after
perspectives trauma and
screening
build skills
and strengths

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 Action Step 9: Address Barriers
Being able to talk openly and problem-solve about concerns related to
screening is important to increase engagement and acceptance of screening.
Below we consider some strategies to address a range of barriers:

“The identified need will exceed “Obtaining consent from parents will
our capacity.” exceed our capacity.”

Set triaging data rules in advance Use passive consent and opt-out procedures

Review existing resources/capacity Share a consistent message in multiple formats

Review surveillance data Engage parents in developing message

Start small, then adapt and scale up Start small, then adapt and scale up

“Our community doesn’t like the idea.” “What will we screen for?”

Involve multiple stakeholders in planning Obtain input on key focus areas to start with

Consider various measures by grade levels, schools,

Use existing community and parent forums
etc.

Start by screening for resilience and strengths Use the SHAPE Screening and Assessment Library

Start small, then adapt and scale up Start small, then adapt and scale up

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Example from the Field
A suburban school district north of Boston, Massachusetts used quality improvement
processes to incrementally build universal mental health screening in the district.
Initial steps included identifying who to screen, choosing screeners that matched
population needs, determining consent procedures and working with a handful of
students to inform and refine the screening process. Within one school year, the district
moved toward full implementation of two large-scale online screenings at the high
school level that integrated a consent and opt-out process, and have since expanded
to elementary and middle schools. Follow up data analysis revealed that 100% of
students who required follow-up received it within 7 days of the screening, with
urgent concerns being addressed immediately upon identification.

Resources: More information on screening in schools

• Substance Abuse and Mental Health Services Administration (SAMHSA)’s Ready, Set, Go,
Review: Screening for Behavioral Health Risk in Schools helps schools through the
process of developing comprehensive screening procedures. This guide also provides
readily available resources to facilitate the implementation of effective behavioral
health screening in schools.
• The National Center on Safe Supportive Learning Environments’ Mental Health Screening
Tools for Grades K-12 provides an overview of screening; outlines important
considerations for screening tool use; and lists example screening tools, including
descriptions, ages served, and reporter information.

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 For more resources,
visit the SHAPE Resource Library at
www.theSHAPEsystem.com

School Health Assessment

and Performance Evaluation System

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 School Mental Health Quality Guide At A Glance:
Screening

UALI
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1 Plan and implement mental health screening

IN D

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IC AT O

Best Practices
• Include students and families in the screening, planning, and implementation processes.
• Identify a culturally relevant screening tool or process that assesses student social and emotional strengths
as well as risk for mental health concerns (e.g., exposure to trauma).

• Share information about screening in multiple formats prior to implementation, with consideration for
diverse cultures and languages.

• Inform students and families about screening procedures in advance of implementation and offer the
opportunity to consent or opt-out.

• Ensure there is an updated list of internal and external mental health referrals and resources.
• Roll out initial screening efforts gradually to ensure effectiveness before scaling up.
• Respond to risk of harm to self and others immediately.
• Have a defined and timely process to assess screening results and further assess needs for Tiers 2 and 3
services and supports.

Tips
• Start the screening process in small increments and scale up to the entire population in a gradual way that
allows your team to gather feedback and build on success.

• You don’t always need to create a whole new team for screening; consider if there are existing processes or
teams that can be expanded or revised.

• Use validated, culturally responsive, trauma-informed screening measures that reflect valued outcomes,
are appropriate to the student population, and in the first language of students and families.

• Ensure the screening team determines effective planning, administering, scoring, and coordinating
processes that are guided by appropriate leadership and staff.

• Consider state laws or district policies that may affect the ability to conduct active vs. passive consent.

Example from the Field

• One suburban school district north of Boston, Massachusetts, used quality improvement processes
to incrementally build universal mental health screening in the district and ensure that students who need
follow-up receive it within a timely manner.
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School Mental Health Quality Guide At A Glance:
Screening

Action Steps
• Build a foundation by: Assembling a core screening team comprising school leadership, staff, and key
community members; Generating buy-in and support by soliciting continuous feedback (via focus groups,
meetings, and anonymous feedback cards); Considering diverse cultural values and barriers as they relate to
mental health screening; Using data to support justification for, and demonstrate the value of, mental health
screening.

• Clarify the goals of screening prior to selecting screening tools or communicating to those outside of the
screening team about upcoming screening administration.

• Identify resources and logistics in terms of staffing and data infrastructure needed for the screening
process.

• Select an appropriate screening tool by considering multiple indicators of students’ mental health, such as
social determinants of health, academic success, well-being, and distress.

• Determine consent and assent procedures while: Deciding if active or passive/opt-out consent is
needed; Aiming to gain students’ voluntary assent for participation in screening, while making clear to
students that there are no disciplinary or academic consequences for choosing not to participate; Providing
a consistent message on the purpose and importance of screening in multiple formats (e.g., phone calls, fliers,
in-person discussions) to students, parents/guardians, and school staff; Acknowledging that some students
and families may fear or mistrust screening, and utilizing cultural liaisons and translators to ensure the
purpose of, and consent to, screening is understood by all families in the school.

• Develop data collection, management, and privacy processes that abide by district guidelines and federal
regulations (i.e., FERPA and HIPAA).
HIPAA).

• Develop administration processes by determining: How to screen (i.e., online platform vs. paper and pencil);
pencil);
Who to screen; When to screen; Which staff will support screening; What standardized scripts will be used.

• Develop follow-up processes which incorporate multiple perspectives, allow for feedback and adaptation,
and swiftly provide appropriate supports and referrals to students who need them.

• Address barriers which may inhibit engagement with and/or acceptance of screening.

Resources
• The Trauma ScreenTIME Courses & • The Student Information Systems Brief
ScreenTIME Schools Course
• The School Mental Health Team Roles and • The SHAPE System Screening and Assessment
Functions Template Library

• Nine Elements of Effective School Community • SAMHSA’s Ready, Set, Go, Review: Screening for
Partnerships to Address Student Mental Health, Behavioral Health Risk in Schools
Physical Health, and Overall Wellness • The National Center on Safe Supportive Learning
• Hanover Research’s Best Practices in Engaging Environments’ Mental Health Screening Tools
Diverse Families for Grades K-12

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