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The Fourth Tier : Modernizing MTSS for Student Mental Health - Armand Pires

The Fourth Tier

Modernizing MTSS for Student Mental Health

By: Armand Pires, Ryan Sherman

eText | 8 January 2026 | Edition Number 1

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Providing an overview of the student mental health crisis, The Fourth Tier shares a framework to support the development of support that schools and districts can enact to better meet the needs of all students. By leveraging the existing Multi-Tiered Systems of Support (MTSS) model as a starting point and adding a critical fourth tier, this book provides a framework for educators and decision-makers to review, plan, and implement an enhanced level of support for their students.
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