Universal screening for complete mental health is proposed as a key step in service delivery reform to move school-based psychological services from the back of the service delivery system to the front, which will increase emphasis on prevention, early intervention, and promotion. A sample of 2,240 high school students participated in a schoolwide universal screening to identify behavioral and emotional distress as well as personal strengths. School psychologists, as part of a multidisciplinary team, coordinated the use of these screening data to engage in preventive consultation with administration to make decisions regarding the refinement and expansion of mental health service delivery options. Schoolwide and individual student prevention and intervention activities were tailored according to screening results. The roles of the school psychologist and multidisciplinary team members are discussed as critical components of this approach to service delivery change. Implications for future consultation research, practice, and training are provided.