What is Multi-Tiered System of Support (MTSS) for Mental Health in School?
A Cautionary Tale
by Sue Greenwald M.D.
The History
In 2004, a re-authorization of the of the Individuals with Disabilities Education Act (IDEA), introduced a law framework called “Response to Intervention” (RTI) intended to help identify students in need of special education. In an October 2023 article by Eesha Pendaharkar in Education Week,
“In addition to testing a student on an IQ test or an achievement test, to see if they had learning disabilities, RTI encouraged educators to try to teach that child in a more intensive way and monitor their response to that.”
During the Obama years of 2014-2015, the U.S. Department of Education developed RTI mission creep, and MTSS was born.
Multi-tiered System of Support (MTSS) was the name given to a framework that would screen all students for indications of not only learning disabilities, but also the added areas of social-emotional, behavioral, and mental health components. From Education Week:
“MTSS essentially offers students who have learning, social, emotional, or behavioral difficulties in general classrooms personalized instruction or support that matches the level of help they need to stay on pace with their peers. If they don’t make sufficient progress, MTSS models require districts to intensify personalized support. Each tier in the framework is supposed to represent a level of intensity of instructional or other support. MTSS is often used in districts as an approach to offer students mental health support, experts said.”
That is how a law intended to better support special ed students became a method to move students into the mental health pipeline.
The Why
Transformational Social Emotional Learning (invented in 2019), also known as “Whole Child Education,” immerses students into a culture (pedagogy) of anti-Christian, anti-nuclear family, neo-Marxist culture of moral relativism and transhumanism. Anyone who follows this substack is aware, and those who are new should search the archives for references to SEL.
Social Emotional Learning is in every school because federal funds are tied to it. It is impossible to avoid.
The more prevalent Social Emotional Learning becomes in a school district, the more problems that district has with behavior. “Moral relativism” means that there is no absolute truth, and each person decides for themselves what is moral. “Empathy” is the primary goal, and empathizing with mis-behavior and sociopathy is prized over consequences or accountability. Students who believe in a moral code are made to feel guilty for their “privilege.” This is the upside-down world our students have been living in.
It isn’t surprising that today’s teens are anxious and depressed.
According to Abigail Shrier in her book Bad Therapy: Why the Kids Aren’t Growing Up,
“Less than half of today’s high school students feel their mental health is “good.” 40% of them have received treatment from a mental health professional. One in six U.S. children aged 2 to 8 years old has a diagnosed mental, behavioral, or developmental disorder. More than 10% of American kids have an ADHD diagnosis-double the expected prevalence rate based population surveys of other countries. Nearly 10% of kids now have a diagnosed anxiety disorder. Teens today so profoundly identify with these diagnoses, they display them on social media profiles.”
The money spent on counseling and medication is astronomical. According to Shrier,
“Over three billion dollars of capital investment poured into mental health tech startups in just the 15 months following the onset of COVID-19.”
The Education cartel, expert in monetizing their failures, are certainly not going to miss out on this gravy train. School based mental health clinics are the shiny new toy. No doubt your taxes will pick up the cost, whether it is through the education budget, state-funded Medicaid, or federally funded Obamacare.
Exhibit A: Benson High School in Omaha.
The only question is - how to fill those clinics?
The How
From the Nebraska Dept. of Education website, The Nebraska version of MTSS appears to be managed by University of Nebraska-Lincoln, as the details are found on a UNL server. Download and read the above document, it has a lot of information, mostly in academic jargon, but it is still illuminating. (“Whole Child” in this context is synonymous with Social Emotional Learning, and the general idea that schools are responsible for every physical and emotional need of the students, not just academics.)
“Specific Goals of NeMTSS Nebraska Multi-tiered System of Support (NeMTSS) is a continuous improvement framework that focuses efforts and support for the Whole Child approach to address the needs of students, including academic, social, emotional, behavioral, physical, and environmental.
This can be seen in explicit acknowledgment that the NeMTSS framework applies to non-academic as well as academic support needs and that the problem-solving framework can apply to non-academic needs.
Though NeMTSS has roots in special education processes, concerted efforts in the NeMTSS Framework 2023 Version aim to involve all educators in supporting all students. NeMTSS is about far more than just special education. NeMTSS will not lead to improved outcomes for any group of students, including students with disabilities and high abilities, unless every educator sees themselves as integral to the system and accountable for its success.”
This tremendous responsibility imposed upon “every educator” explains the fact that teachers are burned out while trying to find the time to teach academics.
But administrators are benefitting. The MTSS model is labor intensive, this is from the Nebraska document, and it represents the personnel just within each school district:
Nebraska is divided in to 5 regions, and each region has these 4 management positions. That is 20 middle management positions. Salaries in the $60,000 to $80,000 range. (Most likely they have other duties as well, but still, it’s about $1.4 million in management):
Then there a couple of State Coordinators: salaries of $90,000 and $113,000. And 6 program staff.
If this system were benefitting students, it might be worth it. That is a judgement call. For the original intent of administering special education, it likely has value. But for the “whole child” vision of supplanting the role of parents, and “preventing” mental health problems, it is a miserable failure for students.
With SEL largely being the cause of increased student “anxiety,” the MTSS prescription for Tier 2 Support is more SEL, and the desired measurable outcome is an increase in “SEL competencies.” Notice a pattern?
On this graphic-Tier one is blue, Tier 2 is yellow and would consist of in-school counseling and group therapy, and Tier 3 (green) would be a referral to the mental health clinic.
The problem begins in Tier 1, with “Universal Supports.”
Per the Texas Mental Health explanatory document:
“Universal Support” presumes that mental health problems can be prevented by teaching kids all about mental health breakdown. Abigail Shrier wrote an entire book on why this is a fallacy, so we won’t belabor the point here, but it is summarized further in this article.
Additionally, Ms. Shrier’s research is backed up here: Every School Board Everywhere Needs to See This Study.
The short version is this: naval gazing and ruminating on your feelings is unhealthy for average kids without mental health problems. It hinders their self-confidence. It causes them to lose focus on tasks and give in to fear and anxiety. Since focusing on tasks is supposed to be the main reason for going to school, it is a detrimental exercise.
The Cautionary Tale
Nebraska has a history of being a late adopter of trends, both good and bad. A case in point is the school choice movement that has succeeded for decades in every state except Nebraska.
Every bad thing in education involves federal grant money going to Non-Governmental Organizations who spread a small amount to the local school districts, convincing them they are getting something. This is a universal truth.
MTSS and “trauma informed education” have been around awhile, and they have been universally destructive. Red states like Arizona and Texas are trying to pry it out, but once you have a constituency for taxpayer dollars, the roots are deep.
Blue States would rather embrace the suck, because in the Marxist worldview, destruction is the goal; deconstruction of religion, patriotism, individual merit, morality, the nuclear family, the bodies and minds of children.
In researching these stories, one gets the strong impression that “mental health” is a Trojan horse for other services. The California clinics are run by Planned Parenthood, and California law allows 12 yr-olds full autonomy to make their own medical decisions:
In New York the hospitals are enjoying access to students:
In Maine, well:
“Dozens of public schools across Maine have opened in-school HealthReach Community Health Centers that offer students birth control, vaccines, mental health care, and possibly sex-change drugs.
Some parents have taken issue with the federally funded medicalization of their children’s schools, especially since Maine law allows clinics to administer certain drugs and services to kids without parental consent — an opportunity that has already been exploited.”
You may be asking “shouldn’t students have access to mental health care?” Yes, but the vast majority of children don’t need it. Children who need it ideally should have access to mental health care with the knowledge, consent, and oversight of their parents or guardians. The problem comes when you use the schools to create a constituency.
When Obamacare made transgender profitable, the schools went full steam ahead with a transgender curriculum. A feature of that curriculum was keeping the lessons and the resulting transitions a secret from parents. Nobody had heard of trans-kids before 2017, which is when the medical reimbursements kicked in. Prior to that date, teachers and counselors were trained to “identify” that kid that could be secretly transitioned. A constituency was created.
Do you believe the hospitals and clinics that sell government-funded “mental health” would be any different? School counselors and teachers are already being trained to identity the “trauma” which is holding back every student from their full potential. It’s called Transformational Social Emotional Learning, also known as Trauma Informed Education, it was invented in 2019, brought to every school through federal “covid grants” in 2020, and it is meant to transform the culture in the Marxist tradition, creating the cognitive dissonance that leads to anxiety, thereby triggering referrals to mental health.
A side benefit is all the profit the clinics, hospitals, and related NGO’s will siphon from the taxpayers. Crazy kids can be created just like transgender kids can be created. The template is already proven.
What Can We Do?
Nebraska parents must be much more vigilant. We have fought the Comprehensive Sexuality battle and have had some local successes with the males in girl’s sports battle. However, the battles will keep coming because Nebraskans have no alternate choices, unless they are able to pay tuition or home school. Property tax relief is a pipe dream if schools are allowed to mission creep into medical care.
DO NOT SIGN any permission slips that allow the school to treat your child for anything without calling you or a designated proxy in case you are not available. OPT OUT of all surveys and SEL. You have the right. SEL is not mandatory.
If you see MTSS being implemented for mental health or “behavior,” ask for details and make sure your children are not “evaluated” if they are normal, healthy kids. The goal of the school is to meddle in your child’s mind in search of a diagnosis. Don’t let it happen to your family.
Teach your kids to stand up for their own privacy. The PPRA is still in effect and the school can be sued (and should be) if they pressure students to talk about their politics, religion, family dynamics, sexuality, mental health, professional relationships (pastor, doctor) or family legal issues. The schools flout that law all the time. SEL demands it. Teach your kids to say “that is private and I don’t have to discuss it.”
Subscribe to this newsletter, it will never have a paywall. It has “pay to comment” simply to keep out the trolls. Read the archives because deeper dives into many of these issues have occurred previously.
The author is a retired Pediatrician and co-founder of Protect Nebraska Children Coalition