Schools have become the most common setting for youth to receive additional supports—including access to mental health services serving as an entry point for identification and subsequent provision of these services. Many schools rely on office discipline referral (ODR) or suspension data as informal screeners for students who may need additional supports. Discipline data may be effective at identifying students with externalizing behaviors, yet students with internalizing behaviors may not engage in behaviors that warrant an ODR or suspension. As such, these students may go undetected in the absence of systematic screenings. This study explored whether a universal behavior screener identified students at risk for externalizing and internalizing concerns who may not have been identified through ODRs. The Student Risk Screening Scale for Internalizing/Externalizing (SRSS-IE) was completed for 1,201 elementary students in 3 elementary schools. SRSS-IE data were used to predict year-end ODRs. Results showed externalizing scores (SRSS-E7) on the SRSS-IE predicted year-end ODRs, with higher SRSS-E7 scores predicting with more ODRs. However, internalizing scores (SRSS-I5) on the SRSS-IE did not significantly predict year-end ODRs suggesting ODRs may not be an effective data source for identifying students with internalizing behaviors absent of externalizing behaviors.