Since its founding in 2006, The REACH Institute has dedicated itself to expanding access to effective, evidence-based mental health care for all children and families. It has provided gold-standard training to over 8,000 clinicians so that more are equipped to spot early signs of children’s mental illness and provide evidence-based care and support immediately in their medical practice. Pulse 2.0 interviewed REACH CEO Lisa Hunter Romanelli, Ph.D., to learn more about the non-profit and its work to advance children’s mental health care.
Dr. Lisa Hunter Romanelli’s Background
Could you tell me more about yourself and your background? Dr. Hunter Romanelli said:
“I am a practicing clinical child psychologist with expertise in cognitive behavioral therapy and years of experience in mental health advocacy and intervention. I have a long-standing interest in mental health that was initially triggered by the difficult experience of seeing my mom suffer from a major depressive episode while I was in high school. At the time, I coped by learning as much as I could about depression and mental health. Thankfully, she was able to receive effective treatment and eventually recovered. I remained interested in mental health, however, and eventually went on to major in psychology in college and receive my doctorate in clinical psychology.”
“I joined The REACH Institute shortly after its formation and currently serve as Chief Executive Officer. REACH, which stands for the REsource for Advancing Children’s Health, is devoted to ensuring that the most effective, scientifically proven mental health care reaches all children and families, especially those who have the least access to care because of economic, geographic, and/or systemic disadvantages.”
“Throughout my career, I’ve been focused on how I can have the greatest impact on improving the mental health of children in our country. I realized that through clinical practice, I could have an impact on a relatively small number of children. I joined REACH to have a large-scale impact on the lives of many children.”
Idea For the Organization
Where did the idea to form the organization originate? Dr. Hunter Romanelli shared:
“The idea behind REACH arose from twin gaps impacting children’s mental health care. First, there are simply not enough mental health providers, especially in our most vulnerable communities, to meet the needs of our children. Imagine the frustration of having a diagnosed mental health issue impacting your everyday life, and you cannot access care for months or even a year. For children in most communities, wait times remain stubbornly long.”
“The second gap is the length of time between the development of scientific knowledge about mental health and the application of that knowledge to help children and teens. Researchers have estimated that it takes about 17 years for new scientific knowledge to make it into clinical practice. Our founder, Dr. Peter S. Jensen, M.D., saw this problem first-hand while serving as the Associate Director of Child and Adolescent Research at the National Institute of Mental Health (NIMH), where remarkable advances were being made in understanding mental health problems and how to treat them, yet this knowledge wasn’t being put into the hands of the providers who could use it to deliver more effective care to children.”
“REACH’s answer to closing these gaps is to bring proven scientific knowledge and evidence-based practices directly to the health care providers who can use it to change lives. We do this by providing intensive, interactive, and sustained training to primary care providers (PCPs), mental health clinicians, parent advocates, and school-based providers. This approach serves both to reduce the time it takes for scientific breakthroughs to make it into clinical practice and to increase the number of health professionals equipped with the skills and confidence to deliver effective mental health care.”
“For example, most PCPs receive little to no training on mental health during their medical education yet are frequently being asked to provide care to their patients with mental health issues. Without mental health skills, they are quick to refer patients, regardless of severity, to specialists, adding to the lengthy wait times for care.”
“REACH knows that PCPs can and do play a critical role in our mental health system, and by empowering them with skills in this area, we can greatly expand access to quality care. I’m proud to say that we’ve trained more than 8,000 PCPs on mental health since our founding. We’ve made remarkable progress, and I know there’s so much more impact we can and will have in the years ahead.”
Favorite Memory
What has been your favorite memory working for the organization so far? Dr. Hunter Romanelli reflected:
“Every time I hear from a provider who was able to help a child suffering from anxiety, depression, or another mental health concern because of REACH training, I’m thrilled.”
“Another high point occurred two years ago when REACH was awarded a three-year grant from the Draper Richards Kaplan (DRK) Foundation. DRK is a venture philanthropy firm that funds organizations addressing a critical social or environmental issue and prioritizes organizations that have evidence of focused alignment, engage in systemic social change, and use data-based decision-making. Receiving a DRK grant has been especially meaningful because it validates that REACH is designed to realize our impact at scale.”
Core Services
What are the organization’s core services? Dr. Hunter Romanelli explained:
“REACH’s core services are its training programs for PCPs and mental health clinicians. Our flagship program, Patient-Centered Mental Health in Pediatric Primary Care (PPP), equips pediatric primary care providers with the latest evidence-based practices and therapies to diagnose and treat mental health disorders. Led by national leaders in child psychiatry and pediatrics, the course teaches PCPs how to correctly identify and differentiate among pediatric behavioral health problems such as depression, ADHD, bipolar disorder, anxiety states (including PTSD), oppositional and conduct disorders, and psychosis. They also learn to effectively manage psychopharmacology, with instruction on how to select medications, initiate and taper dosages, monitor improvements, and identify and minimize medication side effects. Finally, participants learn how to create and implement a treatment plan by mobilizing existing resources like family members and school personnel.”
“REACH also offers the following courses, all of which follow a similar approach of intensive training coupled with sustained coaching and mentorship to support providers in adopting evidence-based mental health tools and skills in their practice:
— Adult Behavioral Health in Primary Care
— Child/Adolescent Training in Evidence-Based Psychotherapies
— Cognitive Behavioral Therapy for Anxiety in Pediatric Primary Care
— Cognitive Behavioral Therapy for Depression in Pediatric Primary Care
— Addressing Trauma in Pediatric Primary Care
— Practical Behavior Management in Pediatric Primary Care”
Challenges Faced
What challenges have Dr. Hunter Romanelli and the team faced in building the organization? She acknowledged:
“The challenge REACH was created to address remains a national issue today: there are not enough trained mental health professionals to serve our young people’s needs.
Consider these facts:
— According to the Health Resources and Services Administration, 123 million Americans with mental health issues live in Health Professional Shortage Areas.
— 60% of psychologists do not accept new patients (HRSA)
Now consider these:
— Approximately 20% of children in the U.S. have a mental, emotional, or behavioral disorder (CDC)
— Of the 100,000 clinical psychologists in our country, only 4,000 are child and adolescent clinicians (American Psychological Association)
— The average school has 1 school psychologist per 1,211 students (National Association of School Psychologists)
— 37% of high school students report persistent feelings of sadness or hopelessness (HRSA)
Early intervention and proper training in evidence-based practices, such as cognitive behavioral therapy (CBT), are essential for improving child and adolescent mental health outcomes. More trained healthcare providers mean better access to quality mental health care for hundreds of thousands of suffering children, teens, and their families.”
Significant Milestones
What have been some of the organization’s most significant milestones? Dr. Hunter Romanelli cited:
“REACH has established four licensed sites (institutions rigorously trained to independently deliver our courses) and is continuing to explore new partnerships to scale our model. We have licensed sites in North Carolina and Virginia here in the U.S., and in the provinces of Alberta and Saskatchewan in Canada.”
Customer Success Stories
When asking Dr. Hunter Romanelli about customer success stories, she highlighted:
“One story involving a 13-year-old girl from Oklahoma, we’ll call her Mia (not her real name) particularly touched our hearts. Mia had been experiencing suicidal thoughts for more than a year–and had even climbed to the railing of a bridge and considered jumping–although she had not discussed those thoughts with anyone.”
“During a routine well visit with her pediatrician, Dr. Noor Jihan Abdul-Haqq, Mia answered questions that brought her suicidal thoughts and feelings to light. Dr. Abdul-Haqq, having completed REACH’s Patient-Centered Mental Health in Pediatric Primary Care (PPP) program, was both skilled and comfortable screening for and treating mental health issues. Dr. Abdul-Haqq administered Mia’s mental health screening just as she now does with all of her patients: using the tools and training gained in REACH’s PPP program. It was this screening that uncovered Mia’s need for suicide prevention assistance.”
“Mia and her family were fortunate because she happened to have a pediatrician who was skilled in delivering mental health care, but that’s not the case for most primary care providers. Dr. Abdul-Haqq worked with Mia and her mom to develop a safety plan and prescribed an anti-anxiety medication. Then, she connected Mia with a counselor in the community who provides cognitive behavioral therapy (CBT).”
“I’m happy to share that Mia is doing much better thanks to Dr. Abdul-Haqq. Stories like this demonstrate that primary care providers quite literally save and transform the lives of children.”
Differentiation From The Competition
What differentiates the organization from its competition? Dr. Hunter Romanelli affirmed:
“Unlike other solutions that focus on increasing the long-term pipeline of mental health professionals, REACH is unique in its approach because it focuses on health professionals already in the field – notably PCPs. This approach leverages the current system and workforce that already serves as the go-to resource for families and children seeking health services and empowers them with the skills and confidence to provide effective mental health care. Primary care providers receive limited training on mental health as part of their medical education, leading to reliance on referrals and reducing access to care throughout the system.”
“PCPs have a clear need for continuing education (CE) on mental health – a gap that REACH fills through intensive, sustained training. While other CE programs provide short, one-off lectures that have proven to have little effect, REACH’s curriculum is built on the science of behavior change and includes ongoing coaching for up to four months. Through this intensive approach, REACH transforms the practices of providers, enabling them to address most mental health cases at the point of interaction (thus, reducing the backlog and providing care to otherwise unserved patients).”
“The bottom line is no other organization provides this gold standard training. Our courses were developed with national leaders and renowned experts in child psychiatry, psychology, and pediatrics, and our curriculum is grounded in the latest scientific knowledge and based on proven instructional approaches of how adults learn best. Every program is rigorously evaluated on an ongoing basis to ensure it teaches the most effective therapies using the most effective learning models.”
Future Company Goals
What are some of the future company goals? Dr. Hunter Romanelli concluded:
“We have a goal to train 16,000 primary care providers in evidence-based mental health care by 2027. Those 16,000 primary care providers could support about 5 million children annually, and that would go a long way toward addressing the needs of children suffering from anxiety, depression, ADHD, and other mental health concerns. ”
“Additionally, as an organization with deep roots in research and academia, we place tremendous value on measuring and evaluating the impact of our programs and have great data on our model. Having proven the efficacy of our training model, we are looking to develop more licensed sites. Specifically, we set a goal of establishing 50 sites in 50 states, where there would be a dedicated training hub in each state to ensure that all providers have the knowledge and skills to confidently deliver evidence-based mental health care.”
