Screening must be completed in a manner consistent with federal and state laws. The process may raise ethical or legal concerns around communication, confidentiality, and family/student rights. Consider:

• Confidentiality and storage of documents and screening results, and who will access the information

• District capacity to follow-up with all students identified to be at-risk or in need of response

• District response if students are identified to be of imminent risk of harm to themselves or others.

Before the screening process, legal guardian(s) must consent, either actively (in writing) or passively (notice with an option to decline). The Protection of Pupil Rights Amendment (PPRA) protects the rights of students participating in “protected information surveys,” including those concerning mental or psychological problems of the student or student’s family. 

The Family Educational Rights and Privacy Act (FERPA) protects students’ education records and personally identifiable information (PII). If school districts partner with medical or mental health organizations, there are additional considerations regarding health records which are protected by the Health Insurance Portability and Accountability Act (HIPAA). Prior parental consent is required before sharing education records or personally identifiable information.

Upon recognizing that a student is at risk of or experiencing SEBMH concerns (whether by results from screening, or signs of emotional or behavioral distress) schools may notify the parent/guardian and refer the student for school-based services or to community services. 

If a student is an imminent danger to self or others (indicators of self-harm, suicidal ideation, or act of violence) schools must immediately respond with appropriate assessment and referral. Select examples of referral/response mechanisms include:

• Check-ins or mentoring with school personnel

• Individual meetings with students/families

• Referral to community organizations for health, MH, and/or social services

• Referral to school personnel (counselor, nurse, psychologist, social worker)

• Small group interventions for students

When referring families to community organizations, it is recommended that districts establish effective referral pathways with clear procedures for managing referrals that allow for exchange and sharing of information.

Universal v. Focused: Districts may plan screening to be universal, focused, or indicated. Universal—All students at all schools. Focused—Select groups by classroom, grade, or special program status. Indicated—Individual factors, For example: exposure to trauma, history of substance use

Formal v. Informal: Question 20 of the Model District Template guides districts to select formal screening tools. A formal screening tool is typically a structured set of criteria (checklist, questionnaires, rating scales) with standard scoring. Informal screening is typically less structured and may consist of open-ended interviews and/or observations.

Comparison to Existing Screening Practices: K–12 districts should already be familiar with the screening process in the contexts of dyslexia, hearing, and vision. In the context of vision, school nurses or trained adults may administer screening to a focused group (by grade) or indicated students (recognized signs of vision deficits). If the results reflect that a student may need further support, then school personnel notify the parent/guardian to recommend further assessment by a physician or optometrist and refer for services beyond the scope of education (glasses or contacts). The school may also implement supports such as preferred seating at the front of the classroom or printed copies of handouts and presentations.

In the context of SEBMH, districts may administer screening tools to be completed by students, parents/guardians, and/or school staff, to assess emotional or behavioral indicators. Districts may choose to screen universally, select a focused group, or indicated individuals. If results indicate that a student may be at-risk of or experiencing distress, then school personnel may notify the parent/guardian and recommend further assessment by a physician or MH specialist and refer for services beyond the scope of education (individual or family therapy, mental health treatment). The school may also implement supports such as check-ins or mentoring with staff, classroom breaks to cope with distress, or creation of safe spaces.