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 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
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.