["Journal of School Health, Volume 96, Issue 8, August 2026. ", "\nABSTRACT\n\nBackground\nSchool nurses increasingly support student mental health, yet how perceived role responsibility and self‐efficacy shape continuing education needs remains unclear.\n\nMethods\nA nationwide cross‐sectional online survey was conducted in Taiwan using probability proportional to size sampling. Among 658 selected school nurses, 305 responded (46.4%). A 33‐item questionnaire assessed perceived role responsibility, self‐efficacy, and continuing education needs across six competency domains. Multivariable linear regression identified predictors.\n\nResults\nMost nurses lacked prior psychiatric/psychology work experience (74.4%). Perceived role responsibility and self‐efficacy were highest for referral/resource mapping and crisis response/safety assessment, and lowest for psychotropic medication management/monitoring. Continuing education needs were high, particularly for crisis response/safety assessment and identification/assessment. Perceived role responsibility was the only significant predictor of continuing education needs, explaining 29.4% of the variance.\n\nImplications for School Health Policy, Practice, and Equity\nTraining should prioritize role‐focused interventions and standardized protocols for crisis response/safety assessment and identification/assessment, with clear medication‐related coordination guidance to reduce role ambiguity.\n\nConclusions\nSchool nurses' perceived role responsibility drives continuing education needs; training should strengthen role clarity alongside skills.\n"]