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HYPOTHESIS AND THEORY article

Front. Educ.

Sec. Mental Health and Wellbeing in Education

Volume 10 - 2025 | doi: 10.3389/feduc.2025.1553528

Implementing multi-tiered systems of support in rural schools: A practice perspective for improving mental health care for underserved youths

Provisionally accepted
Christopher Kearney Christopher Kearney *Michael Fensken Michael Fensken Randolph Dupont Randolph Dupont
  • University of Nevada, Las Vegas, Las Vegas, United States

The final, formatted version of the article will be published soon.

    Rates of mental disorder for youth have increased substantially over recent years and this trend, coupled with persistent barriers to community-based care, has led researchers and others toward a “where they are” approach that emphasizes preventative and health promotion practices within ecologically valid environments such as schools. A key mechanism of this approach involves multi-tiered systems of support (MTSS) models that allocate supports based on student need across multiple domains of functioning. MTSS models have been implemented with moderate success but students in rural districts may be underserved. This article introduces a blueprint for a sample MTSS approach in rural schools by initially presenting their challenges and advantages as well as implementation science frameworks, and particularly the School Implementation Strategies, Translating ERIC Resources (SISTER) project, geared toward educational settings. The blueprint incorporates SISTER pillars rated highest for importance and feasibility throughout linchpin strategies to set the basis for the MTSS model; readiness strategies to determine needs, structure, and feasibility; Tier 1 strategies to implement preventative practices and address emerging cases; Tier 2 strategies to provide early intervention services for acute cases; Tier 3 strategies to provide intensive intervention services for chronic and severe cases; and strategies to enhance sustainability (including fidelity) and expansion. The blueprint thus represents a blending of emerging implementation science ideas with real-world constraints often evident in rural schools to provide a practice perspective and one set of ideas to promote discussion and innovation for a key underserved student constituency.

    Keywords: Rural schools, multi-tiered systems of support, implementation science, School Implementation Strategies, Translating ERIC Resources, School-based teams, school mental health, implementation sceince

    Received: 30 Dec 2024; Accepted: 24 Mar 2025.

    Copyright: © 2025 Kearney, Fensken and Dupont. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Christopher Kearney, University of Nevada, Las Vegas, Las Vegas, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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