Telehealth & Multi-Tiered System of Supports (MTSS)

Our nation’s K-12 students are struggling with the toll that the last two-plus years have taken on their mental health. With students of all ages experiencing a deluge of mental health challenges, and struggling to get the support they need, our nation’s youth are in the midst of a mental health crisis. Today, 44% of high schoolers feel sad or hopeless, and suicide is the leading cause of death among children ages 10 to 14. 

Students are looking for mental health support, and many are turning to where they already spend much of their time–school. When surveyed, 70% of public schools reported an increase in students seeking mental health services, and 76% reported an increase in school staff voicing concerns about their students exhibiting depression, anxiety, and trauma symptoms. 

Schools are the  heart of a community, a place students and their families trust and rely on for services and support. Schools want to support their student’s mental health, but many lack the resources to meet the growing demand for services. Almost all public schools (96%) today offer some mental health support, but only 12% strongly agree that they can effectively provide mental health services to all students in need. In most districts, student need overwhelms current strategies and resources. 

School-based mental health services can improve access to care, enable early intervention and prevention, reduce stigma, increase utilization, reduce chronic absenteeism, and improve student health outcomes. Especially for underserved communities, school-based mental health services can help reduce barriers to care and ensure that all students who need services are able to access them. 

The need is clear, but how can school districts respond? How can districts expand and augment existing mental health strategies? What solutions and interventions can districts build into their Multi-Tiered System of Support framework to address the needs of students effectively?

Using a Multi-Tiered System of Supports (MTSS) Framework 

Typically, schools use a three-tiered framework to deliver instructional or behavioral interventions to students (some use four). A multi-tiered system of support (MTSS) enables the delivery of interventions unique to the student's needs–it avoids a one-size-fits-all approach to behavioral and social-emotional interventions.

The MTSS framework looks at more than how a student performs in the classroom–it aims to consider all parts of a student's life including their emotional and behavioral health, and how they're affected by social determinants and other nonacademic factors. 

Understanding that the school setting is a fitting place for mental health interventions, schools are implementing robust MTSS frameworks that incorporate school-based mental health services. 

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Every school and district will have different strategies, depending on resources and the specific needs of their student and family population. 

Not only are the tiers of MTSS viewed through the lens of the interventions, but they are also determined by student need. To determine student needs, districts consider a myriad of data sources, including attendance, behavioral referrals and information, academic outcomes, and much more. There are traditionally three tiers of student needs:

• Tier 1: students that do not require any specialized intervention
• Tier 2: students that require some level of intervention beyond the services  universally offered‍
• Tier 3: students that need more intensive interventions

It is important to note that interventions can be used across student tiers. For example, a tier 2 intervention, like mental health counseling, might be able to meet the needs of both tier 2 and tier 3 students. 

Hazel Health mental health services as a tier 2 MTSS intervention

As the mental health needs among our nation's youth continue to grow, schools are working to provide more robust, innovative solutions to respond to the growing demand for mental health support. Districts across the country, spanning diverse demographics and various degrees of local partnerships, have implemented Hazel Health into their MTSS frameworks as a tier 2 intervention. 

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Expanding staff capacity

Many schools experiencing strained resources and staffing shortages have turned to virtual solutions, like Hazel, to augment and expand their existing mental health service capacity. According to Kaiser Family Foundation, 60% of schools cite insufficient staff coverage as a critical factor limiting their ability to provide mental health services to students effectively, and 57% cite inadequate access to mental health professionals. Hazel streamlines the workflow of the schools' existing school health team by connecting students to locally licensed therapists. 

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Reducing wait times

When a student requires support, mental health interventions must be delivered quickly–it can be problematic, and sometimes dangerous for students to wait on long wait lists. The longer the wait time, the more likely a student's mental health challenges might progress and the less likely that youth is to ultimately avail themselves of the resources. When a student is referred to Hazel for a clinical assessment, families are contacted to schedule an appointment within 48 hours. 

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Connecting students to locally licensed, culturally responsive therapists 

Hazel's mental health service offers short-term therapy with care coordination–an ideal tier 2 solution to meet the mental health needs of tier 2 and often tier 3 students. Hazel offers teletherapy sessions with locally licensed mental health professionals who are experts in the unique needs of children and teens. When a student needs support outside of Hazel, like long-term mental health care, or specialized, more intense services, Hazel's team helps connect the student to resources within their community. 

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Providing school-based and at-home supports

Understanding that students spend most of their time at school, Hazel offers therapy sessions to students at school and at home. Without long wait times, students can connect with a therapist in a secure, private environment in either setting. 

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Leveraging evidence-based strategies

During telehealth visits, therapists use evidence-based strategies to help students explore what they're feeling. Therapy aims to help students develop coping strategies and tools to improve their mental wellness. 

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Clinical outcomes in a short-term therapeutic model

Hazel has preliminary data sets, using common measures such as pre/post scores on the GAD7 and PHQ9, as well as PCOMS to demonstrate both therapeutic alliance, and positive clinical outcomes in as few as 3 to 7 sessions.

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Connection to long-term services

Some students require access to longer-term care after their six or so counseling sessions with Hazel. For a student who requires more  tier 3 interventions, Hazel helps coordinate care and connects the student to the long-term services they need, like a psychiatrist or inpatient or outpatient care.
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Telehealth services within a multi-tiered system of supports

Every student needs some support, whether it's tier 1, 2, or 3. With students' needs for mental health interventions growing, the percentage of tier 2 and 3 students is increasing. With that growth comes a need for advanced tier 2 interventions. Districts across the country are responding to this need, finding creative solutions to support their students holistically–academically, physically, and mentally. Hazel Health is grateful to be a part of the solution.

‍Learn more about how Hazel works with districts

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