About

Dr. Cruz is committed to improving the mental health of children and adolescents in under-resourced settings worldwide by meeting them where they are every day — in their schools. Her independent research program centers on Tealeaf (Teachers Leading the Frontlines — Mental Health), a teacher-led intervention that trains and coaches classroom teachers to deliver Education as Mental Health Therapy (Ed-MH)1,2. Ed-MH is a novel mental health therapy she and her team invented that expands typical classroom behavior management techniques teachers already use to now be grounded in evidence-based therapies. Tealeaf is a community-initiated care model: rather than taking on a separate clinical duty, teachers tweak what they already do in the classroom to be therapeutic. Tealeaf was first developed in Darjeeling, in the Indian Eastern Himalayas, a setting reflective of under-resourced environments worldwide. The program is now being piloted in the Philippines, where the team is testing a cascade implementation model in preparation for scaling Tealeaf to all of Manila, reaching approximately 150,000 students; and in North Carolina, where the pilot spans grades K–8 and includes a middle school extension of Tealeaf. The Tealeaf NC pilot is housed within the UNC Suicide Prevention Institute and conducted in partnership with the UNC School of Education, where Dr. Cruz holds a secondary appointment with the School Psychology Program.

An externally funded feasibility trial has demonstrated promising results, and Dr. Cruz is currently conducting a Type 1 hybrid effectiveness-implementation stepped wedge cluster randomized trial in Darjeeling to evaluate Tealeaf’s ability to improve outcomes for children at-risk of or experiencing mental health conditions. She is also expanding the program to adolescents in Darjeeling, across both middle and high school grades.

Dr. Cruz additionally pursues research on suicide prevention locally. Drawing on her clinical expertise in inpatient child and adolescent psychiatry, she collaborates with faculty across UNC, including the School of Education and the School of Social Work, on projects ranging from optimizing adolescent school reintegration after hospital discharge for suicidal thoughts and behaviors (STBs), to developing virtual reality as a novel therapeutic supplement to inpatient care to improve school reintegration in this population, to collaborating on BELIEF (Behavioral Engagement by Leaders of Interfaith to Expand the Frontlines), a new SPI-based pilot adapting the Tealeaf community-initiated care model for pastors and other faith leaders to deliver upstream suicide prevention and mental health support to their congregants.