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Think In Tiers and Focus on the Positive

Focusing on mental illness, rather than mental health, can leave educators feeling overwhelmed. This is mostly because school administrators and staff do not have the training or mandate to intervene at this level. However, educators are very well-positioned to contribute to positive mental health amongst students and to assist with early identification and ongoing daily support to students who struggle with problems in this area. 

Honing our skills related to upstream mental health promotion and prevention in schools allows us to contribute meaningfully without working beyond our professional boundaries. The Aligned and Integrated Model (AIM), which outlines a multi-tiered system of support for Ontario schools, emphasizes that most of the work of schools is, or should be, focused on tier 1 (mental health promotion) and tier 2 (prevention) services. 

The Aligned and Integrated Model or AIM is a triangle that shows the three tiers of student mental health support in Ontario.

The first level – tier 1 – is good for all – Tier 1 is the foundational everyday work you and your staff do to welcome and include students, to understand them and build knowledge of mental health, to promote mentally healthy habits and to partner with parents, students and other staff to create a supportive environment. Most of the mental health work in schools is at this level.

The second level – tier 2 – is necessary for some – Tier 2 focuses on prevention and early intervention. In every class and school, there will be some students who may need additional support in the classroom. You can help by reinforcing skills and working to remove barriers to learning.  School mental health professionals and others with specialized skills provide intervention services, like structured psychotherapy, at this level.

The third level – tier 3 – is essential for few. Tier 3 services support students requiring more intensive assessment and intervention services. Although it will always be necessary for schools to provide some level of tier 3 service (because students cannot or will not access outside supports, and to manage crisis events as they arise), our role in schools is to help students to access appropriate community or health services and to provide needed ongoing care while students are at school.

When you think in tiers, you can effectively design and monitor mental health services at the system and school level. It’s less overwhelming when we consider our role in the broader system of care.

Schools are uniquely positioned for mental health promotion, early identification, prevention, and early intervention services. While we have a supportive role to play in crisis management and can provide accommodations and classroom strategies for students struggling with a mental illness, we do not have responsibility for intensive mental health services.

We need to work in partnership with community and health partners, as part of the system of care. Our priority contribution is upstream promotion and prevention.

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