Overview

Providing an overview of the student mental health crisis, The Fourth Tier shares a framework to support the development of support that schools and districts can enact to better meet the needs of all students. By leveraging the existing Multi-Tiered Systems of Support (MTSS) model as a starting point and adding a critical fourth tier, this book provides a framework for educators and decision-makers to review, plan, and implement an enhanced level of support for their students.

Full Product Details

Author:   Armand Pires ,  Ryan Sherman
Publisher:   Bloomsbury Publishing Plc
Imprint:   Rowman & Littlefield
ISBN:  

9781475875041

ISBN 10:   1475875045
Pages:   176
Publication Date:   19 March 2026
Audience:   Professional and scholarly ,  Professional & Vocational
Format:   Hardback
Publisher's Status:   Active
Availability:   Manufactured on demand  
We will order this item for you from a manufactured on demand supplier.

Table of Contents

Chapter 1: Introducing a New Approach to an Escalating Problem Part 1: Defining the Challenge Chapter 2 - Unraveling the Crisis: The Rise of Youth Mental Health Challenges Chapter 3 - The Limitation of the Pediatric Mental Health System Chapter 4 - The Impact of the Youth Mental Health Crisis in Schools Part 2: An Expanded Planning Framework Chapter 5: The Multi-Tiered Systems of Support Framework and Tier 4 Chapter 6: What is MTSS Tier 4 and Why Do Schools Need it? Chapter 7: Advantages of a MTSS Tier 4 Model Chapter 8: Planning for Success Part 3: Putting the Plan into Action Chapter 9: Building a MTSS Tier 4 Model Chapter 10: Planning for Financial Sustainability Chapter 11: MTSS Tier 4 Model Examples Chapter 12: A Call to Action Part 1: Defining the Challenge Chapter 2: Unraveling the Crisis: The Rise of Youth Mental Health Challenges The Good News First The Benefits of Socializing Online Helicopter Parenting Has Its Perks The Youth Mental Health Crisis In America The Pre-Pandemic Rise In Prevalence The Post-Pandemic Youth Mental Health Crisis A Product of Their Environment: What’s Fueling the Mental Health Crisis Digital Media and Youth Mental Health Youth Social Media Use and Mental Health Concerns Perfecting Your Online Image The Fear of Missing Out (FOMO) Mobile Devices and Sleep The Assault on Family Protective Factors Key Takeaways What’s Next? Chapter 3: The Limitations of the Pediatric Mental Health System Where Have All the Mental Health Providers Gone? The Plight Of the Pediatrician Referring To The Abyss Show Me The Money…Wait, What Money? The Ultimate Bottleneck The Search For Pediatric Mental Health Appointments Key Takeaways What’s Next? Chapter 4: The Impact of the Youth Mental Health Crisis on Schools The Impact The Student Impact on the Staff and School Climate School Leaders’ Perspective Accepting Our Responsibility Key Takeaways What’s Next? Part 2: An Expanded Planning Framework Chapter 5: The MTSS Framework and Tier 4 A Brief History The MTSS Tiers - An Overview Time for an Expanded MTSS Model A Revised Model What does a Tier 4 MTSS Model look like? Key Takeaways What’s Next? Chapter 6: What is MTSS Tier-4, and Why Do Schools Need It? Limitations of MTSS Tier 3 A Reactionary Approach to Support A Sloth-Like Approach to Receiving Supports Challenges with the Outpatient Referral Model MTSS SEL Tier-4 Essential Components of an MTSS Tier-4 Model Key Takeaways What’s Next? Chapter 7: Advantages of the Tier-4 Model Student Benefits Associated With the Tier 4 Model An Ounce of Mental Health Screening is Worth a Pound of Cure Increased Mental Health Access = Better Education Wraparound Care Improves Student Outcomes School and District Benefits Associated With the Tier 4 Model Key Takeaways Next Steps? Chapter 8: SEL Tier 4 Components Proactive Mental Health Screening And Identification Practices Before You Start Approaches To Universal Mental Health Screening Social And Emotional Learning Competency Screening Social, Emotional, And Behavioral Functioning Screening Mental Health Disorder Screening Gatekeeper Training Selecting A Universal Screening Tool Or Gatekeeper Training Dedicated Care Coordination The Need For Care Coordination? Defining Care Coordination Benefits Of Care Coordination Students and Families School Counselors Community Partner Spotlight: Care Solace In-School Outpatient Therapy Benefits Identifying Partners Teletherapy Wrap-Around Mental Health Services Model Components Benefits School-Based Wrap-Around Mental Health Models Key Takeaways What’s Next? Part 3: Putting the Plan into Action Chapter 9: Planning for Success Conducting an Environmental Scan The Needs Assessment Community Partner Spotlight: The JED Foundation Building Support and Momentum Launching the Steering Committee Developing a Communication Plan Community Partner Spotlight: kartoonEDU Key Takeaways Next Steps? Chapter 10: Planning for Financial Sustainability Staffing for Sustainability Searching for Resources Developing and Nurturing Relationships Existing Resources Operating Budgets Community Partner Spotlight: Effective School Solutions Local and City/Town Resources Town/City Supports Local Health Agencies National Organizations and Governmental Agencies Federal Agencies Private Foundations Seed Grants Key Takeaways What’s Next? Chapter 11: MTSS Tier-4 Model Examples Case Example # 1 Lakeside Public Schools Community Partner Spotlight: Cartwheel Case Example # 2 Riverbend Area School District Case Example # 3 Cedar Ridge Local School District What would your district’s Tier-4 program example look like? Key Takeaways What’s Next? Chapter 12: A Call to Action A Farewell to Traditional MTSS What Lies Ahead for School Mental Health? Chapter 13: Resources

Reviews

This book provides a concise, applied research approach to support mental health in schools. It outlines a proactive approach for school leaders to address mental health. The authors' expansion of MTSS to include a fourth tier is an essential shift to effectively respond to the ongoing student mental health crisis. This book is an essential guide for school leaders to work within their sphere of control to address it. -- Rosemary Reilly-Chammat, EdD. * Director, Office of School Health and Wellness, Rhode Island Department of Elementary and Secondary Education * Two experienced educational leaders, Sherman and Pires, take readers on a journey that begins with the significant challenges currently facing the children’s mental health services system and leads to a comprehensive guide for school staff that addresses those challenges. By highlighting the importance of partnerships between schools and community organizations, they reveal practical strategies to improve youth mental health services. -- Jennifer Green, PhD. * Professor, Boston University Wheelock College of Education and Human Development * As a school superintendent, I am continually searching for innovative approaches to address the complex challenges our students face. The mental health crisis among school-aged children has escalated to unprecedented levels. The Fourth Tier: Modernizing MTSS to Support Student Mental Health is not just timely; it is an essential resource for educators and administrators grappling with these urgent issues. It offers a thoughtful, well-researched roadmap to address one of the most pressing issues in education today. -- Jeffrey J. Marsden, EdD * Massachusetts Superintendent of Schools *

Author Information

Armand Pires, PhD, has served as Superintendent of Schools in Medway, Massachusetts since 2015. Prior to this role he served as assistant superintendent, director of curriculum, principal and assistant principal at the middle and high school level, as well as a teacher at the middle and high school level. Armand was also recognized as the 2025 Massachusetts Superintendent of the Year. Ryan Sherman, DBH, has been the director of wellness for a Massachusetts school district since 2016, bridging school and mental health services. He previously worked as a behavioral health provider at Massachusetts General Hospital and is a senior professor in social and emotional learning at Bay Path University . Dr. Sherman has received multiple awards, including the MIAA Wellness Coordinator of the Year. For more, visit www.SELTier4.com.

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