- Darjeeling, India is often described as the “Queen of the Hill Stations”, a city built in India atop the rolling emerald green foothills of the Eastern Himalayas with views of the imposing Kangchenjunga (the third tallest mountain in the world).
The lush landscape and fresh mountain air combine to produce some of the world’s most renowned teas.
While scenic, Darjeeling’s landscape combined with its politics, minority and scheduled caste/scheduled tribe populations, and lower available resources together contribute to the area being marginalized within India. The vast rural region surrounding Darjeeling is mountainous in terrain, has poor infrastructure, and is struck regularly by monsoons, making travel and every day tasks logistically challenging. Primarily Nepali-speaking, the communities we work with are poor, marginalized, and made up primarily of an ethnic minority population of day laborers, making access to services, such as children’s mental health care, rare.
In Darjeeling, we have been testing and implementing Tealeaf since 2016. Currently, we are in the final year of our Type 1 hybrid effectiveness-implementation trial. We are also adapting Tealeaf to the adolescent age group.
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2. Manila, Philippines, the densest city in the world, is the vibrant capital of the Philippines. It is a sprawling urban hub along the shores of Manila Bay, where Spanish colonial architecture, jeepneys, and bustling public markets exist alongside gleaming skyscrapers and massive shopping malls.
Despite its cultural energy and historical richness, Manila’s school system faces deep structural challenges. With over 150,000 elementary school children across the City of Manila’s public schools, most classrooms are overcrowded, teachers are under-resourced, and access to mental health professionals is extremely limited. Poverty, urban congestion, and displacement further compound the barriers to care, particularly in Manila’s many informal settlements.
The communities we work with often come from intergenerational cycles of poverty. Many families live on daily wages or subsist on government support. Teachers serve as front-line lifelines—not only for education but for emotional and behavioral guidance. In Manila, we have been testing Tealeaf since 2023. Currently, we are in the process to scaling to all of the City of Manila’s public elementary schools. We are also in the process of planning for scale nationwide across the Philippines and incorporating Tealeaf into teacher training prior to graduation from college. In short, Tealeaf will be the elementary school mental health ecosystem for the Philippines, training all elementary school teachers to have mental health skills as part of their teacher education before then stepping into schools where Tealeaf is the system for school mental health.
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3. North Carolina, United States stretches from the beaches of the Outer Banks to the Blue Ridge Mountains in the west, offering a strikingly diverse geography—and similarly diverse communities. A state rooted in agricultural and industrial histories, North Carolina is now a rapidly growing hub of biomedical research, technology, and education.
Yet across its rural counties, especially in the Appalachian and Coastal Plain eastern regions, children’s access to mental health care is fragmented or absent. In many rural districts, there are no child psychiatrists at all. Even in urban school systems, persistent racial disparities, provider shortages, and school counselor overburdening mean that mental health needs often go unmet.
The communities we serve in North Carolina span diverse families, many of whom face economic hardship, geographic isolation, or historical disenfranchisement. Teachers often become the first to notice distress, yet are rarely trained to respond with structured support. Tealeaf aims to bridge this gap by equipping educators to deliver care in a way that resonates with North Carolina’s ethic of community resilience and care-for-your-own. We are in the middle of a two-year RCT to show its usability and impact in North Carolina, in elementary and middle schools from the mountains (Blue Ridge) to the sea (Outer Banks).