The majority of youth in need of mental health services do not receive intervention as many are not identified as having a problem or their families experience practical or attitudinal barriers that interfere with service utilization. The school environment provides a unique point of access to reach all children, yet this setting has been neglected as a means to both identify children in need of services and develop interventions to reduce barriers and engage families in service use. Presently, only 2% of schools screen for mental health problems, and most engagement interventions are conducted in clinics or developed for families already enrolled in treatment. Thus, engagement interventions developed in schools for families of at-risk children in the early stages of help-seeking have not been previously explored. This study examined the effects of an engagement intervention on parent adherence to recommendations among children screened for social, emotional, behavioral, and adaptive problems in the context of Kindergarten entry. The engagement strategy was a feedback session designed to reduce barriers to service initiation. The study aims were to (1) obtain a demographic profile of at-risk, rural Kindergarteners and barriers to mental health services reported by their parents; (2) evaluate the impact of an enhanced feedback session on parents' adherence to recommendations, compared to a standard feedback session; and (3) examine predictors of adherence to recommendations provided in the feedback session. Results showed that of 597 children screened using parent and teacher report of the Behavior Assessment System for Children, Second Edition (BASC-2), 306 (51%) were identified as at-risk. The profile of these youth indicated that the majority had parents who did not report a problem and who had high perceived barriers scores. Parents interested in obtaining feedback were randomized to standard and enhanced feedback conditions. At follow up, results provided preliminary evidence that the engagement strategy resulted in increased parent adherence to sharing screening results with medical doctors. Analyses also revealed that barriers uniquely predicted parent adherence to sharing screening results with teachers. The findings from this study provide overwhelming evidence for the importance of school-based mental health screening and suggest the role of barriers warrants continued examination in the context of engagement interventions for families in the early stages of seeking mental health services.