Mona Potter of InStride Health On Raising Children Who Are Mentally & Emotionally Healthy

An Interview With Maria Angelova

Family meals: Research shows that regular family meals together are protective in multiple areas. This one can get tough to implement with working parents and multiple competing demands in everyone’s schedule, but it doesn’t have to be dinner. The point is to establish a deliberate time when family comes together for food, fun, and conversation. This also helps create a baseline of communication among family so that it’s less strange if you have to have a talk about challenges or concerns.

Our children are facing challenges that didn’t exist just a short while ago. They are growing up with social media, constantly being connected, and the hurried pace of life today, as well as the pandemic, and the often frightening news. In short, our children are facing unprecedented mental health challenges. Anxiety, depression, and even suicide are on the rise. As parents and educators, what can we do to raise children who are mentally healthy? In this interview series, we are talking to authors, parenting experts and mental health professionals who can share their expertise and advice on Raising Children Who Are Mentally Healthy. As a part of this series, I had the distinct pleasure of interviewing Mona Potter.

Mona Potter, MD, is a Harvard-trained clinician who co-developed the McLean Anxiety Mastery Program at McLean Hospital in Massachusetts. On the leadership team of the McLean Institute for Technology in Psychiatry, she helped spearhead the hospital’s telehealth pilot program and use of virtual reality for anxiety exposure therapy with a passion for incorporating cutting-edge technologies into treatment. She is a co-founder of recently launched InStride Health, a technology-enhanced mental health treatment for children and adolescents (ages 7–22) struggling with moderate to severe anxiety and OCD.

Thank you so much for joining us in this interview series! Before we dive in, our readers would love to hear a little about you. Inspire us with your backstory!

I’m a child and adolescent psychiatrist and Chief Medical Officer at InStride Health. I trained and worked in the MGH/McLean/Harvard Medical School system for almost two decades before co-founding InStride Health, where we provide care for pediatric anxiety and OCD. I’ve been in the trenches with families and have seen the meaningful impact compassionate treatment backed by science can have on lives. I’ve also seen how hard it is for most families to get this treatment, which is incredibly frustrating and heartbreaking. While I had always thought that I would spend my whole career in academic medicine, the more I experienced how broken our mental health system is, the more I realized I needed to step out to build something different — something that brings diverse thinkers and systems together to solve this seemingly impossible problem. As a clinician and a mom, I’m driven by the mission to help fix the broken mental health care system to help families get the care they need.

What are some lessons you would share with your younger self if you had the opportunity?

Speak up and hold yourself accountable to be part of the solution, even if you feel you are too young or haven’t yet learned and experienced enough to make you feel valuable. Don’t be shy; reach out to, learn from, and surround yourself with people smarter than you, especially if they think differently from you. And recognize that even experts will not have all the answers all the time. Feel confident in what you know and believe, but hold on to humility, recognizing that the world is nuanced and complicated, and we all make mistakes. Most importantly, remember the value of human connection — we are stronger and healthier as a community that respects and cares for each other, so use that as your guiding post through all of the twists and turns of life.

None of us are able to experience success without support along the way. Is there a particular person for whom you are grateful because of the support he/ she gave you to get where you are today? Can you share that story and why you are grateful for that person?

In every phase of my life, I have had many people influence me in meaningful ways. That being said, my parents and my sister have been with me every step of the way, inspiring me, supporting me, and shaping me into the person I am today.

My parents have always modeled hard work (push yourself out of your comfort zone, persevere to get things done), creativity (keep an open mind and find new ways to think about and approach things things), and commitment to community (we’re all human — our connections matter, and we need to look out for each other), and that has stuck with me to this day.

My parents immigrated to the U.S. from India at a young age with only each other to depend on. They stuck to their values and built a life for their young family that was full of love, meaning and connection. I’m humbled when I think of my parents’ story; that story’s influence on me has been constant throughout my life.

Are you working on any exciting new projects now? How do you think it might help people?

InStride Health is my exciting new project, and even though I’ve never worked harder (and I have worked really, really hard), I feel like I’m living a dream. Our vision is to help solve the pediatric mental health crisis, and while that’s not a small task, I believe we will get there. Each and every person who has joined our team comes with great knowledge and expertise, AND they’re driven by heart and purpose (our culture is critical). So we truly are able to combine rigor and expertise with human compassion and care to help solve these really tough problems together.

We opened our clinical doors in Massachusetts in fall of 2021 (after almost a decade of running a model program at McLean Hospital), and it has been incredibly meaningful to see children, teens, young adults, and their families gain hope and strength through our work together. Anxiety and OCD can be exhausting, and even devastating, so our goal is to help by offering treatment that works to any family that needs it.

Ok, thank you. Let’s talk about raising emotionally and mentally healthy children. In the Western world, humans typically have their physical needs met. But what has led to the tremendous downgrade in emotional and mental health that we are seeing today, especially for children?

This is a question that gets discussed frequently and comes with many answers, including greater recognition of mental health challenges, exposure to negative influences through social media and technology, economic stressors leading to family stress, increased social isolation, exposure to traumatic events, etc. (the full list is long, and different families are impacted by different things in different ways).

Prior to the pandemic, we were seeing a greater recognition of the struggles that children are facing, and I think most people will agree that the pandemic has made things worse. Children are part of a system that has been stressed in many ways, from finances to social unrest and more. When the pandemic first hit, the first wave of mental health emergencies came from the adults (in fact, some hospitals diverted children’s beds to make room for adult units due to that early demand). Children’s struggles came in a second wave. When adults are not doing well, it trickles down to the children (for example, research shows that treating depressed mothers has a high impact on their kids’ mental health).

More and more people (adults and children) are being pushed beyond our threshold for productive coping. Stress is normal and natural — everyone experiences it, and our bodies are designed to handle it. But we are not designed to handle chronic and unrelenting stress. Eventually, we fatigue physically and mentally.

What is lacking in the mental health arena? Why are so many of our children struggling today?

There are so many opportunities for improvement in our mental health arena. Here are just a few:

1. Limited access to care: We have treatment that works that is comparable to the management of chronic diseases in other medical specialties. What we don’t have is the number of clinicians we need to meet the need for that treatment.
2. Problems with affordability of care: Many clinicians bill families out of pocket, which makes that care unreachable for many families.
3. Lack of consistency in the treatment that is offered: We have treatment that works, but is not always the treatment offered when families seek help. If you were to go to multiple endocrinologists for treatment of diabetes, you would generally get a similar treatment regimen from all of them. Mental health treatment does not have this consistency. Because there is such high demand without enough providers, a broader spectrum of treatment practices are permitted and provided, many of which do not stand up to scientific rigor.
4. Lack of transparency in treatment expectations and outcomes: Again, if you were to go to an endocrinologist for treatment of diabetes, you would be given clear expectations for where your blood sugar should trend, and measurement of blood sugar would lead to adjustments in your treatment regimen. Measurement-based care is not the current norm in mental health treatment, which makes it even harder for families to know what to expect and if they are getting the right treatment.
5. Lack of coordinated care: Kids exist in a system that includes family, school and other environments. If we want the treatment to have lasting impact, we need to include the system. It is also important that clinicians caring for the kids (therapists, psychiatrists, pediatricians, etc.) talk with each other and work together to create a surrounding system of support. Time and expense leads to system-based care being more the exception than the norm.
6. Need for a reimbursement model that works for both payors and providers: Fortunately, we are working with innovative payors who are also committed to addressing this problem.

How does technology play into the equation of mental and emotional well-being? What about social media?

Technology is neither all good nor all bad, but we have to be deliberate about how our kids integrate it into their lives. It is a tool, and how they use that tool impacts the outcome. For example, video games generally are not inherently bad (in fact, there is research that shows some advantages). But playing video games at the cost of physical activity, engaging in other hobbies or completing schoolwork can become a problem.

Social media’s big impact is its ability to amplify a message; it extends the reach and shelf life of ideas, good and bad. We need to teach our kids to practice the same awareness on social media as they do in their physical lives — consider how interactions make you feel as you decide how much to keep coming back to them, be aware of peer pressure, consider how to trust the information coming your way before universally believing what you see, be careful with strangers, think about how you’re using your time, etc.

Obviously, this is a huge issue, and it seems to be growing. What are some small, practical tips, or tweaks, that parents and educators can easily implement to help their children who are struggling?

1. Compassion before direction: Listen and validate a child’s feelings and make sure you understand where they are coming from prior to jumping into commands, expectations, and problem solving. The compassion can be a quick one-liner — just something to help them feel connected rather than alone and on guard.
2. With regards to media, don’t make it black and white: For example, don’t treat all screen time as all bad or all good. Particularly for younger kids, digest media with them and help them understand how to navigate it. And model the behavior you want to see — as adults, we also are at risk for getting caught up in technology and practicing something different from what we preach.

In your professional opinion, what are certain triggers or signs that the state of a child’s mental and emotional health is not at its best? What is the best way to be proactive and address these signs from the get-go?

Look out for changes in functioning. Is the child starting to avoid places, activities, or people? Is the child requiring more prompts to do things and withdrawing from people and/or things that used to be easy to do? Are they experiencing more irritability or seeming more distressed?

The ultimate way to be proactive is to aim for family meals during which parents or caregivers and kids spend time with each other and create the habit of family talking with each other.

When approaching a child with concerns, it often can be helpful to start with compassion and validation (demonstrating that you understand their perspective). Get a sense for how they are thinking and feeling, and let them know that they have a support system there to help. Reaching out to the child’s pediatrician or a point person at school can be a helpful first step in identifying the problem and thinking about how to tackle it.

Do you think we can do a better job of educating our children about their emotional and mental health? What would that look like?

As parents, schools and pediatricians, we’re definitely getting better, but there are opportunities to improve everywhere, and ideally that learning is tied to actual everyday activities (it sticks better that way). They don’t have to be big lessons, and some of it is modeling the behavior we want to see because kids often watch us more than they listen to us.

Our family has started a weekly family meeting. It used to be adults only, but now that our kids are older, we have started to include them. We set an agenda and talk through issues. It’s not long, but it’s an opportunity to model that we care about what they think and feel.

Okay, fantastic. Here is the main question of our interview: Can you share with our readers your “5 things parents can do to raise children who are emotionally and mentally healthy”? Please share a story or example for each.

1. Take care of your own mental health, and be aware of how your emotions are showing up at home: This is important for many reasons, including an ability to effectively respond to our children when there are challenging moments and an ability to model effective coping with all that life throws our way. I will never forget an activity that the teachers at my son’s preschool set up during a parent night. We paired up and one adult acted as the parent while the other acted as the child. The task was to get the child’s winter gear on before heading to school, but we were already late and the child didn’t want to wear winter gear. We did the exercise twice, first with no additional instruction and then again after being asked to be mindful of the impact of our emotions on the child. It was striking to see how much more effective it was, and how much better it felt, to notice the emotions and take a breath to bring down the intensity. Life is busy with multiple competing demands, so it’s easy to get swept up in the stress of the moment. Mindfulness helps us be more deliberate in how those emotions are impacting us and those around us.
2. Encourage approach, perseverance and a growth mindset: It is so painful to watch your child struggle, but sometimes letting them struggle is how we love them the most. For instance, when my son pitched for his baseball team, he had an entire inning where he could not catch a break. Every pitch was either a major hit or a ball. My heart was racing, and I just wanted his suffering to end. But he played out the inning. He could have come out of that game saying he never wanted to pitch again (and frankly, I would have been OK with that to save my own heart), but instead, his father encouraged him to give it another try. But first, he practiced pitching in the backyard and persisted in building new skills. In the next game he pitched he struck a kid out. He never would have experienced that win if we had protected him. He actually wrote a story about it at school when asked to reflect on a time he felt proud of himself.
3. Know your child: What is their temperament, and how does that fit with your style as a parent? Being attuned to their needs, particularly when they might be different from what you need, can be quite powerful. With my kids, it was clear from an early age that while they were both adorable and sweet and amazing, my son and daughter were very different from each other and required different approaches, to the point where we actually chose different preschools when the time came.
4. Choose your battles and be predictable: When approaching a decision with your child, think deliberately about which bucket it fits into. A) Let them have the win. B) Negotiate with them. C) No negotiating — parent has say. I use this with my kids a lot. For example, when my daughter decided that it hurt too much when I brushed her hair, I decided not to argue and let her go to school with tangled hair. It seems small, but it took out the struggle in the morning before school, and tangled hair caused no harm (other than my worry that others would judge me for not being an attentive mom, which I got over quickly). Piano practice, however, has been a negotiation. I know that starting to learn a new instrument is painful and not fun, but once you pass a certain hump, it can get very fun. So I felt it was important for the kids to persist in practice, but they found it boring to practice. So we agreed that we would start with five minutes of practice every morning before school to develop a habit and give them a chance to progress. My son will now sit on his own and play piano for fun, which we all enjoy! Non-negotiables in our house are related to safety. No hitting or disrespectful behavior, listen 100% when we tell you not to cross the street, etc.
5. Family meals: Research shows that regular family meals together are protective in multiple areas. This one can get tough to implement with working parents and multiple competing demands in everyone’s schedule, but it doesn’t have to be dinner. The point is to establish a deliberate time when family comes together for food, fun, and conversation. This also helps create a baseline of communication among family so that it’s less strange if you have to have a talk about challenges or concerns.

Do you have any favorite books, podcasts, or resources you recommend to our audience reading this interview?

Two books that have really stuck with me as a parent and clinician:

Paul Tough — How Children Succeed

Daniel J Siegel and Tina Payne Bryson: The Whole Brain Child

You are a person of great influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

There are a lot of meaningful movements that need to happen, but I’ll stay in my lane in the pediatric mental health space. I believe we need more accountability in our field, and that is the movement I’m taking on with my team at InStride in collaboration with many smart, similarly driven teams (knowing fully that we can’t do this on our own). We have to hold ourselves accountable for improving access to cost-effective mental health care and ensuring that the child and family are matched with the care they need so that they never have to worry alone. We need to hold clinicians accountable for providing compassionate, data-driven care that works. We also need accountability for how we care for our providers. Sometimes, when you’re in a caregiver position, it’s easy to forget that you’re human as well. You also have needs, stressors, and limits, which can led to quite a bit of burnout among health care workers. Children’s mental health is now a national emergency, and we need to hold ourselves accountable to make the changes needed to address it.

What is the best way for our readers to continue to follow your work online?

Follow our work at InStride.Health.

This was very inspiring. Thank you so much for the time you spent on this. We wish you only continued success.

About The Interviewer: Maria Angelova, MBA is a disruptor, author, motivational speaker, body-mind expert, Pilates teacher, and founder and CEO of Rebellious Intl. As a disruptor, Maria is on a mission to change the face of the wellness industry by shifting the self-care mindset for consumers and providers alike. As a mind-body coach, Maria’s superpower is alignment which helps clients create a strong body and a calm mind so they can live a life of freedom, happiness, and fulfillment. Prior to founding Rebellious Intl, Maria was a Finance Director and a professional with 17+ years of progressive corporate experience in the Telecommunications, Finance, and Insurance industries. Born in Bulgaria, Maria moved to the United States in 1992. She graduated summa cum laude from both Georgia State University (MBA, Finance) and the University of Georgia (BBA, Finance). Maria’s favorite job is being a mom. Maria enjoys learning, coaching, creating authentic connections, working out, Latin dancing, traveling, and spending time with her tribe. To contact Maria, email her at angelova@rebellious-intl.com. To schedule a free consultation, click here.