This investigation tested the internal structure of scores on the Mental Distress Response Scale (MDRS), a peer-to-peer mental health support screening tool, with a national sample of 237 adolescents from 111 high schools in 30 states. Results revealed psychometric support for the scores on the MDRS and demographic differences in students' responses. We discuss implications for how school counselors can use the MDRS to enhance peer-to-peer mental health support as part of a comprehensive school counseling program.