Mental Health Blog

From Screening Tools to Systems Change: Tips for Putting Your REACH Training Into Practice 

• May 22, 2025
• The REACH Institute
• Child mental health, Pediatric primary care

When providers attend their first Patient-Centered Mental Health in Pediatric Primary Care (PPP) training with REACH, many leave feeling empowered and excited to implement their new knowledge. But having evidence-based tools is only the first step in supporting mental health for children and adolescents. We asked several PPP alumni—and one who is now a faculty member—to share their best strategies for successfully integrating PPP training into patient care.

As PPP alum Sarah Lester, MD, explains, “Is it comfortable to change practice habits? No. But being able to offer better treatment for my patients with mental health needs is one of the most satisfying and rewarding parts of my practice. Dive in, embrace the discomfort and give it a go. You won’t be disappointed when you find your new normal.”

Start with One Small Change That You Control

REACH faculty member Amy Dryer, MD, advises PPP alums to start small and resist the temptation to do everything at once. 

For her part, Dr. Dryer started with one change: screening all pediatric patients for depression and, when needed, getting comfortable prescribing SSRIs. As she grew confident with that first step, she branched out to screening for and treating more conditions. Today, clinicians across the larger practice refer their most complex mental health cases to Dr. Dryer and pediatric mental health has become a core part of her job. 

Share What You Have Learned with Peers and Colleagues

Beyond using PPP skills with patients directly, teaching colleagues and students about PPP tools is one of the most powerful things clinicians can do. As a residency director, PPP alum Barbara Miller, MD, teaches her residents “how to care for pediatric patients straight from the knowledge I gained from PPP.” 

Dr. Dryer also advises not to be put off by “reluctant providers” who don’t want to add mental health care to their services. “We all work together like a complex puzzle,” she explains. “Colleagues who are specialists in other areas, like complex medical or genetic conditions, now know to immediately refer patients to me when they suspect mental health involvement.” 

Look for Opportunities for Systems Change

“After a REACH training, it’s easy to feel the weight of ‘“I’m going to do this now.’ and for system leaders to think, ‘You got the REACH training, you’re good to go,’” explains Anu Partap, MD, MPH, a PPP alum who brought REACH training to a major pediatric health system in Texas. “But health systems need to support clinicians in using the practices learned in REACH.” 

Some of the changes PPP alums have found both achievable and useful within diverse practices and health systems include: 

• Allowing evidence-based screeners to be part of electronic health records (EHR).
• Educating colleagues on using screeners and, when needed, referring patients to you or other REACH-trained clinicians. 
• Implementing universal screening for all patients when they check in, for example a 4-question PHQ-2/GAD-2 screener. If questions are positive, the medical assistant rooming the patient can follow up with a one-page GAD-7/PHQ-9—all before the clinician enters the room. 
• Educating clinicians and billing departments on coding and billing to increase payments for mental health screenings and services. 
• Training schedulers on how to best schedule for mental health services. For example, Dr. Dryer has created a short-hand system to communicate with front desk staff. At the end of a visit, she gives parents’ an index card with the child’s initials, type of mental health appointment needed, and frequency of appointments recommended.
• Advocating for dedicated medical assistants for each clinician, which reduces burnout, creates more continuity of care for patients, and increases efficiency for mental health service provision, as MAs can also learn to deliver screeners, create a safety plan, etc. 
• A more significant change, Dr. Dryer got board approval to change her schedule to serve more mental health patients. She now provides dedicated mental health appointments two afternoons per week, with longer appointment times. 

Depending on a clinician’s role, it may take time to help leadership understand the need for changes. PPP alums report that the more clinicians there are involved in uplifting the need for changes, the more likely they are to become priorities. Clinicians can also demonstrate the financial benefit of changes, such as improved billing and capitation—meaning keeping patients within a practice for mental health services, rather than referring them elsewhere. 

Bring REACH Training to Your Institution

One of the most striking examples of systems change to support pediatric mental health comes from Dr. Partap. After attending a PPP course, Dr. Partap set out to bring REACH training directly to pediatric providers at a large health care system in Texas. 

Partnering with leaders in the health system, as well as frontline pediatricians, psychiatrists and psychologists, Dr. Partap rallied support, permission, and funding for a private client PPP course. Still, few believed clinicians would want to attend. “The goal for our first PPP training in 2020 was to have 10 clinicians sign up,” recalls Dr. Partap. Instead, 60 clinicians signed up—and REACH trainings became an annual offering. 

As more clinicians completed the PPP course, the need for systems change to support patient mental health care also became a growing priority. Dr. Partap helped create a behavioral health leadership group to make sure clinicians’ feedback was heard. In addition to implementing smaller shifts, like those described above, the group is now piloting a care coordination model for REACH-trained physicians.

From Knowledge to Impact

Whether you’re just beginning to integrate what you’ve learned or leading large-scale change, every step counts. For more tools to support your journey: 

• Visit our Free Resources page
• Explore common topics and conditions on the Mental Health Blog
• Access evidence-based Rating Scales
• View more tools, like the GLAD-PC.