Thrive Dispatches

Isolation among families is usually discussed as a feeling. This conversation puts it somewhere more

concrete: in what a community has built and kept.

Laura Huerta Migus is Director of Fellowship Alumni Engagement and National Activation & Impact at

Ascend at the Aspen Institute. Before that she spent more than a decade leading the Association of

Children’s Museums. In this episode of Thrive Dispatches she joins Dr. Matt Biel to talk about the places

families have left.

She works from a simple taxonomy. First spaces are homes. Second spaces are the ones we have to go

to, like hospitals and schools. Third spaces are the ones we choose. Those are the ones going away.

She is specific about how. Across much of the country, people get from place to place in a vehicle and

alone. There are no sidewalks. Getting to a third space is not tenable, or the space was developed out

during the urban design process.

We tend to read the result as a set of private choices. She does not. A parent’s options are limited by

what their community is able to offer them, and that comes down to investment.

Then there is the evidence from lockdown. Zoos, aquariums and botanical gardens had some of their

best attendance years, because they were outdoors and open. Take away nearly every option and

people did not stay home. They went to the one that was left.

Children’s museums are her counterexample. She calls them one of the only spaces in most

communities “designed for children on their terms.” A pediatrician’s office is not. Neither is a child

welfare office. Neither is a classroom, at least not through a child’s own agency, and neither are most

playgrounds.

In this video episode of Thrive Together, hosts Maya Smith and Jason Lehmbeck speak with

Rebecca Ralston, Senior Director of Early Childhood and Preventive Health at Special

Olympics, and an alumna of the Thrive Center’s Innovation Hub fellowship. Young Athletes, the

early childhood program she has led for ten years, reaches about 350,000 children across more

than 170 countries. Roughly 53 million children under five have intellectual and developmental

disabilities.

The guiding theme of the conversation: ask first, then build. When the idea for a Young Athletes

app met resistance inside the organization, Rebecca’s team went back to the drawing board

and ran listening sessions with families, early childhood experts, and health providers. “Let’s not

let the app be the end goal, but let’s see what families need, and if the app meets that, then

we’ll be able to sort of fit that in.”

With Head Start, they mapped their program against the entire set of Head Start standards.

With tribal Head Start programs, they were told not to arrive with something already finished, so

they spent years co-building an indigenized Young Athletes. “So instead of just using those

foundational motor skills to build to soccer, we’re building to the tribal game.”

Efren Aguilar is a researcher and community engagement specialist at the University of California, Los

Angeles, working at the intersection of early childhood measurement, spatial epidemiology, and systems

transformation. Over a career spanning more than three decades, he has worked in domestic violence

prevention, refugee support, homelessness, public health, and early childhood systems, treating each

role as a study of a different stage of human development.

In this episode of Thrive Dispatches, Aguilar joins Dr. Matt Biel to discuss the 15 years he has spent

building geographies of resilience, a way of mapping not only where communities are struggling but

where they are doing well against the odds. The work started with an observation he could not yet

explain. The same neighborhoods kept surfacing across unrelated data sets and methodologies, and

funders were reading those concentrations as need. Concentrated hardship, he argued, is only half the

measure. It says nothing about what people on the ground have already solved.

In this video episode of Thrive Together, hosts Maya Smith and Jason Lehmbeck speak with Maria Barrera, Co-Founder and CEO of Clayful and an alumna of the Thrive Center’s Innovation Hub fellowship. Clayful partners with schools, its financial and distribution partners, to give students across the country on-demand coaching by text. 

Young people hear the statistics about a youth mental health crisis and conclude that other people need the help more than they do. So they wait, the problem grows, and by the time they reach out, it’s become severe. 

Clayful launches to every student in a school, not only the ones already flagged, and it sets the threshold for a conversation as low as it will go. A crush counts. A new anime show counts. One student opened a chat unsure his problem was “a big enough deal.” His dog had died. “That moment of connection is actually healing, too,” Maria says.

When the threshold is that low, students that the system rarely sees show up. Maria shares that 46% of chats come from boys, and about 80% of students who identified with higher levels of anxiety on the PHQ-4 were using Clayful. The moment school partners became believers, she says, came when Clayful flagged a student who was thinking about ending their life and had never been on their radar.

The conversation also gets practical about why this works as a business. Schools are the front door to mental health, Maria says: students trust them, they are already there, and there are no transportation barriers. Because Clayful collected clinical measures from day one, prevention becomes something you can see. “You can’t retroactively create data, but if you have it, then you can retroactively analyze it and see things in the data that are pretty magical.” By her account, 90% of students who started the year low-need stayed there, twice the rate of students who did not use Clayful. And with grant funding sunsetting, Clayful is pairing school partnerships with insurance reimbursement so the support outlasts any single grant.

Dr. Shabab Wahid is an assistant professor of global health at Georgetown University’s School of Health and a global mental health researcher working at the intersection of culture, climate, and wellbeing, with active studies in Bangladesh, Kenya, Senegal, Nepal, and Sri Lanka.

In this episode of Thrive Dispatches, Dr. Wahid joins Dr. Matt Biel to explore what cross-cultural science tells us about how people experience mental distress. They start with the study that drew Wahid into the field, in which people with schizophrenia in the United States described voices that were harsh and punitive, while people in India and Ghana described companions and friends.

They then trace his research in Bangladesh linking sustained heat, separated statistically from floods and storms, to depression and anxiety, and the grief he documents in communities watching their home environments change in front of their eyes.

And they dig into his central methodological contribution: how to build mental health interventions that communities recognize, trust, and want to use. That means learning how a community understands the mind, which words people use for distress, and what a good outcome looks like in local terms, from addressing tension in South Asia to supporting a calm heart in Senegal. 

The lesson of the conversation is a sequence: listen first, then adapt, then treat. A clinic for depression sees no visitors due to stigma; a program for tension brings people back, with friends or spouses at the second session. The sequence holds at home too, down to the question therapists in Nepal ask their young clients: depression like normal depression, or depression where you need help?

In this video episode of Thrive Together, hosts Maya Smith and Jason Lehmbeck speak with Dr.

Mary Ann Woodruff and Rachel Lettieri, LCSW, of Pediatrics Northwest, a pediatric group that

has served families in the South Sound region of Washington for more than 50 years.

Mary Ann is a general pediatrician who saw patients for 36 years and is now the Medical

Director of Care Transformation as well as the Washington Medical Director for Reach Out and

Read.

Rachel directs Care Transformation and built the practice’s community health worker division.

Both were fellows in the Thrive Center’s Innovation Hub.

Pediatrics Northwest treats the pediatric medical home as a universal touchpoint, the one place

nearly every family returns to with their child, and uses it to bridge physical health, behavioral

health, and unmet social needs.

Community health workers from the community accompany families: they help navigate

systems like early intervention and behavioral health, reduce stressors, and build the confidence

to make a first call. The team has protected one non-billable day a week for community health

workers to be out building relationships with the resources they connect families to, a choice

they have held for four years even while billing Medicaid for those services. Their work grew

from a Medicaid waiver grant for collaborative care and behavioral health integration in 2018

and 2019, and it is part of Pediatrics Supporting Parents, a five-community national initiative

with Zero to Three to strengthen early relational health in well-child visits.

The through-line, in Mary Ann’s words: children’s brains develop in relationships, not systems,

and so our systems have to catch up with that science.

In this episode, Dr. Matt Biel speaks with Alison Peak, a clinical social worker

specializing in early childhood mental health and the Executive Director of Allied

Behavioral Health Solutions, a behavioral health practice with sites across Tennessee.

Before any of that, Alison grew up deep in the Appalachian Mountains of Virginia, in a

place where predictable routines created safety even during times of scarcity, and

where relationships were the foundation of a wide web of informal support.

In their conversation, Alison and Matt explore the difference between formal systems,

the agencies with long acronyms and eligibility requirements, and the informal ones, the

networks of relationships and predictable rhythms that decide who shows up for whom

when times get hard.

Alison’s clinical anchor is a definition she returns to often. “My favorite definition of infant

and early childhood mental health is the capacity to love well and grow well.”

For young children, she explains, relationships are not one factor among many. They

are the thing that determines whether a child makes it to adulthood at all.

Introducing Thrive Together — a new video podcast from the Thrive Center at Georgetown University, now appearing right here on the Thrive Dispatches feed.

Hosted by Maya Enista Smith and Jason Lembeck, Thriving Together features the same commitment to honest, solutions-focused conversation as Thrive Dispatches — with a more personal, co-hosted dynamic and a focus on the entrepreneurs, families, and practitioners building something new.

In this first episode, Maya and Jason sit down with Mallika Reddy Pajuri, co-founder and CEO of PsycheCare — a peer coaching platform that supports families in the weeks and months after a child's mental health crisis. Mallika shares how her own chronic illness shaped PsycheCare's model, why the company put parents (not clinicians) at the center, and what it looks like to build a Medicaid-focused mental health startup from the ground up — including three months living in Minnesota, a rented Jeep, and a crocheted emotional support pickle.

This week, Dr. Matt Biel speaks with Jamal Berry, President and CEO of Educare DC, a model early childhood program serving more than 375 children prenatal to age five across two campuses and partner sites in Wards 7 and 8 of Washington, DC. Jamal joined Educare DC in 2013 as an infant and toddler mentor teacher and has moved through nearly every layer of leadership since. He is also an Ascend Fellow at the Aspen Institute.

In their conversation, Jamal and Matt talk about what drew Jamal to early childhood work in the first place (his mother, the first in her family to attend college and the kind of person who always pulled out an extra plate at Sunday dinner), and what has kept him there. They explore what it really means to close the opportunity gap, not only for the children Educare serves but for the families and communities around them. As Jamal puts it: “We’re the workforce behind the workforce.”

This week, Dr. Matt Biel speaks with Dr. Christine Page-Lopez, Associate Medical Director at Neighborhood Health community health centers in Northern Virginia and the Virginia Medical Director for Reach Out and Read. Dr. Page-Lopez also holds a master's degree in public health and works at the intersection of primary care, community building and advocacy.

In their conversation, Christine and Matt talk about how holding both a clinical and public health perspective shapes her practice, how she sees partnerships with schools and community organizations as critical to her ability to take care of her patients, and how she's working to shift pediatric care from a model focused on illness and threats to health to one that emphasizes family strengths and children's innate capacities for connection and resilience.