Skip to main content

Christina M. Cruz, MD, EdM is a child global mental health and school mental health researcher, a practicing inpatient child and adolescent psychiatrist, and a mental health systems consultant. Her research program centers on increasing access to child mental health care through alternative systems. Currently, she is focused on task-shifting indicated mental health care to teachers in Darjeeling, India for children in primary schools, scaling this care to the public schools of Manila, Philippines, and adapting this care to the middle school age group for a rural North Carolina context. She is also now working to extend the care in Darjeeling to adolescents, as well as using tenets of the care to address mental health and climate change concerns among Darjeeling farmers.

She is an Assistant Professor of Psychiatry at the University of North Carolina at Chapel Hill (UNC) School of Medicine with a joint appointment in School Psychology at the UNC School of Education. She also serves as the Associate Head of the Division of Global Mental Health within UNC Psychiatry. She additionally serves as founder and Principal of Ligaya, LLC a mental health systems consulting firm. She completed her Bachelor of Science in Economics at the Wharton School of the University of Pennsylvania, her Masters in Education at the Harvard Graduate School of Education, and her MD from Harvard Medical School. She completed her general psychiatry residency and child and adolescent psychiatry fellowship at UNC.

Her work is funded by the American Academy of Child and Adolescent Psychiatry, the Thrasher Research Fund, the Doris Duke Charitable Foundation, the UNC Children’s Research Institute, the UNC Carolina Asia Center, and the Mariwala Health Initiative. She has also been awarded an institutional KL2 training award. Tealeaf and Ed-MH findings have been published in Global Health Action, International Journal of Mental Health Systems, Global Public Health, Frontiers in Psychiatry, and Frontiers in Pediatrics.



Task-shifting is a form of care in which non-professional (“lay”) individuals are trained to deliver health care under supervision. In mental health care, evidence is building for the efficacy of lay counselors to improve mental health symptoms and outcomes for individuals requiring indicated levels of care, especially relevant for lower-resources areas of the world where mental health care access to mental health care is particularly poor. In this talk, we will examine the evidence for task-shifting mental health care to lay counselors, largely studied for the adult population. We will then explore burgeoning evidence that task-shifting mental health care may also be efficacious for adolescents and children, with a special focus on the growing evidence supporting an early signal of the efficacy of Tealeaf (Teachers Leading the Frontlines). Tealeaf is a task-shifting system of care in which teachers deliver indicated mental health care to their elementary school students. Within Tealeaf, teachers deliver a novel modality of therapy called “education as mental health therapy” (Ed-MH). Ed-MH therapeutic techniques are evidence-based in mental health but also aligned with teaching processes and classroom behavior management.

Recording of Forum Session