School-based mental health screening has been identified as a major component of social, emotional, and behavioral multitiered systems of support models, and a promising practice that can be used to address unmet mental health needs of children and adolescents. However, there are frequently noted concerns about the feasibility of implementing school-based screening programs. In this case study, findings from a school-university partnership, intended to address the most commonly reported screening concerns while reducing screening burdens on the school, are described. Students enrolled in a public middle school in a large, urban city in central Texas completed the self-report version of the Behavioral and Emotional Screening System. Participation in initial school-based screening was high (n = 390), with 35.9% of participants considered at-risk. Screening results informed immediate school-based counseling. However, subsequent screening and comprehensive evaluation for at-risk students--completed at an external university clinic--were low. Implications of these findings, as well as recommendations based on the study methods and related literature, are discussed.