Background: The prevalence of adolescent major depressive disorder increased from 8.3% in 2008 to 14.4% in 2018, and suicide is now the second leading cause of death among U.S. adolescents.

Objective: Describe the process of community-engaged research methods used to develop a randomized clinical trial (RCT) comparing the effectiveness of school-based universal depression screening on depression identification and treatment engagement, compared with standard symptom-based depression recognition.

Methods: We engaged stakeholders with personal or professional expertise and schools enrolled in the study. Qualitative methods aimed to elucidate barriers and opportunities during RCT development.

Results: Stakeholders were instrumental in all phases of RCT development. Qualitative feedback from participating schools, students, and parents informed RCT development and implementation.

Conclusions: The inclusion of community-engaged research methods provided opportunities to collaboratively address barriers to RCT design and implementation with school communities. This dialogue was invaluable in establishing relationships to further address mental health and other controversial adolescent health topics in future research.