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We investigated characteristics of school-based mental health screening using multiple-gating (MG) approaches through a systematic review of the literature and proportional meta-analyses of screening participation and risk identification. The main analyses included 38 studies conducted in the United States. Pooled estimates indicate that approximately 72% of eligible students participated in initial screening, with 82% of eligible students participating in a second assessment. Approximately 24% of students participating in initial screening were identified as at-risk for mental health difficulties, with 65% identified at-risk in a second assessment. Participation rate was significantly associated with the type of consent process used, with participation rates of 55% and 58% in initial screening and a second assessment, respectively, for studies with active consent processes, and participation rates of 90% and 96% in initial screening and a second assessment, respectively, for studies with passive consent processes. Implications for future research and practice are provided. Impact Statement This study presents an initial review of school-based, multiple-gating (MG) mental health screening studies. Results indicate that low participation is a significant barrier to screening, which may influence the generalizability of research in this area. More inclusive practices are recommended, both to increase the number of students supported through screening and to improve research.

Meta-Analysis of Proportions of Students Screened and Identified in Mental Health Multiple-Gate Screening Research