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The largest philanthropic organization in India will scale up an innovative mental health training program created by Christina Cruz, MD, EdM, to help children with mental health issues.


The largest philanthropic organization in India will scale up an innovative mental health training program created by Christina Cruz, MD, EdM, to help children with mental health issues.

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Christina Cruz, MD, EdM

July 10, 2019

Christina Cruz, MD, EdM, who developed a program to enable teachers in rural areas to recognize and respond therapeutically to children with mental illness, was elected as the recipient of the American Academy of Child and Adolescent Psychiatry Junior Investigator Award and a Thrasher Research Fund Early Career Award for her work.

As a 2018 Global Health Scholar through the UNC School of Medicine’s Office of International Activities, Cruz created the TeaLeaF (TEAchers LEAding Frontline) Program for the Darjeeling Hills of India through the Broadleaf Health and Education Alliance and Darjeeling Ladenla Road Prerna. The TeaLeaF program focuses on task-shifting mental health services to local community leaders and teachers. It helps teachers learn new strategies for classroom and behavior management.

Also, the Tata Trusts, the largest and most influential philanthropic organization in India, plans to scale her intervention to Nagpur, a city of 5 million people, as the children’s mental health focus of their major mental health initiative, Udaan. They have named Cruz as a technical advisor to Udaan and co-advisor to the Trusts with the likes of Vikram Patel, as well as authors of the Mental Healthcare Act, 2017, which now governs the national mental health policy of India.

The Tata Trusts envisions rolling out Cruz’s intervention state by state over the course of years.

Expanding access to children’s mental health care is a crucial global health challenge. About 20 percent of all children suffer from a mental health condition; most will remain undiagnosed, untreated and affected lifelong. Fundamental underlying cause of this treatment gap is insufficient human resources. Innovative care models are urgently needed to address this challenge.

“We will train classroom teachers to deliver evidence-based mental health care as a first step in overcoming the treatment gap and increasing access to care for children in resource-limited settings,” Cruz, an Assistant Professor in the Department of Psychiatry, said. “Our project will assess the acceptability of leveraging classroom teachers to deliver necessary mental health care to children in rural primary schools of the Eastern Himalayas. This contribution is significant because it provides an initial test of the acceptability of such an intervention for teachers, who would be shouldering the work of a children’s mental health professional above typical duties, and children and families, who would have an authority figure be knowledgeable of a sensitive struggle.”

After demonstrating feasibility, this model could be tested for broad applicability for increasing access to care and reducing the child mental health treatment gap worldwide. This model could then begin to address key identified gaps in mental health, including in the Grand Challenges in Global Mental Health Initiative led by the Nation Institutes of Mental Health.