Magnifying impact through mentorship and technology

In 20 years as a faculty member and much-valued mentor, Ken Ruggiero has leveraged technology to improve mental health care quality and access

by Kimberly McGhee

For Ken Ruggiero, Ph.D., it’s all about making an impact on the lives of others. In his 20 years as a faculty member at MUSC, first in the Department of Psychiatry & Behavioral Sciences and now the College of Nursing, he has earned a reputation as a highly valued mentor and an innovative researcher developing interventions to help those struggling with trauma and mental health issues in the community. As Smart State Endowed Chair of the College of Nursing-based Technology Applications Center for Healthful Lifestyles (TACHL), he supports other researcher-innovators in optimizing technology to multiply their impact on improving care. His is a career marked by a laser focus on the needs, especially mental health needs, of others and how to meet them.

Finding a path

What now seems like a predestined path was less than clear to Ruggiero as an undergraduate. It wasn’t until his junior year that he found his calling while working at a summer camp for youth struggling with behavioral issues.

“I very much enjoyed connecting with the kids, learning more about their day-to-day struggles and trying to help them to increase their resilience,” he said. “That experience was a life changer for me in many ways. It's what made it clear to me that I wanted to go into the child mental health field.”

A research assistantship with an undergraduate mentor led Ruggiero to an interest in traumatic stress and childhood trauma, which he pursued in his graduate work. He first came to MUSC as a clinical intern, drawn by the reputation of the National Crime Victims Research and Treatment Center and its faculty, who would become valued mentors and collaborators.

“It was a natural decision to come here because this was one of the best places you could go to learn from and partner with a wide range of top-notch traumatic stress researchers,” he said.

Pointing the way for others

Perhaps because of the importance of mentors and unique learning opportunities in finding his own career path, Ruggiero has placed a high value on mentorship during his career at MUSC. He is passionate about mentoring not only trainees, who will be the next generation of mental health researchers, but also the staff who make community-based interventions possible. Ruggiero believes that taking the time to meet regularly and really get to know mentees’ dreams and challenges is critical to a successful mentoring relationship.

“That’s crucial to keeping that relationship strong and making sure that you have your finger on the pulse and can give good guidance,” he said.

His dedication is not lost on his mentees.

“Dr. Ruggiero is selfless in dedicating his time to others and is truly a mentor in every sense of the word,” said Hannah C. Espeleta, Ph.D., an assistant professor in the College of Nursing.

Tonya Hazelton, MS, director of Nursing Diversity, Equity, Inclusion, and Belonging and program manager for TACHL, echoes that praise.

“Dr. Ruggiero gives a level of support and generosity to his supervisees that is unprecedented by any other mentor that I have ever had,” she said.

In 2022, Ruggiero was honored with the Peggy Schachte Research Mentor Award, one of the awards of which he is most proud.

Technology as a multiplier of impact

Although technology has come to define Ruggiero’s career, it was a far cry from what it is today when he first arrived at MUSC. Smart phones didn’t yet exist, and “most people were not connected to the Internet, or if they were connected, were using dial-up modems,” he said.

The full potential of technology to improve mental health care quality and access were not yet clear. But there were inklings. A colleague, Heidi Resnick, Ph.D., had begun to use videos in the emergency department to reduce the risk for anxiety. As uptake of the internet grew, Ruggiero and others wondered whether pairing such interventions with technology could help more people.

“We thought, ‘wouldn't it be cool if we could take some of these concepts and scale them using technology?’” said Ruggiero.

TACHL was growing as a center for innovation under the leadership of Frank Treiber, Ph.D., and Ruggiero joined as co-director in 2014 before taking the role as director in 2018.

Under Ruggiero’s leadership, TACHL has focused on how technology can improve quality of care and how it can be used to scale interventions to help entire communities.

Ruggiero and TACHL partnered with the Red Cross to create, test and implement Bounce Back Now, a free app available in English and Spanish that is designed to improve the emotional health of adults and families affected by natural disasters or mass violence incidents. Ruggiero’s work showed that families affected by disasters actively use the app and that it can improve their emotional and behavioral outcomes.

Another TACHL-led initiative, the Trauma Resilience and Recovery Program (TRRP), leverages technology to meet the overlooked mental health needs of hospitalized trauma patients who have experienced life-altering incidents, such as gunshot wounds, stabbings and bad car crashes.

“Many trauma centers don't address the mental health needs of these patients, or at least historically, they haven't,” said Ruggiero.

The largely telehealth-based program, which provides education, screening, assessment, referrals and behavior therapy, has now been adopted by 12 trauma centers in the U.S., most of them in the Carolinas. Tatiana Davidson, Ph.D., co-director of TRRP, led this implementation initiative with funding from The Duke Endowment.

In 2007, the Sofa Super Store Fire in North Charleston claimed the lives of nine firefighters and left their colleagues grief-stricken. Partnering with the National Fallen Firefighters Foundation, Ruggiero, Davidson and TACHL established the Center for Firefighter Behavioral Health in 2011. In one program offered by that center, firefighters are featured in videos to educate other firefighters, describing their struggle with the emotional aftermath of tragedies encountered on the job, their hesitance to acknowledge those struggles due to stigma and the motivation that finally led them to get the help they needed.

Most recently, through his SPARK (Supporting Providers and Reaching Kids) initiative, Ruggiero and his team at TACHL have created a digital platform for interactive games that can support providers in providing high-quality mental health care for children.

“There are a lot of providers who are overwhelmed with dozens of patients, and they're expected to be expert in way too many types of treatments,” said Ruggiero. “I'm very excited about our potential to transform how mental health care is provided in a more engaging way in mental health clinics.”

Through SPARK, kids and their providers can use tablets to complete drag-and-drop activities, play trivia-style card games or view animations to learn about skills in behavior management. Clinicians join kids in completing the activities, strengthening provider-patient relationships and improving children’s engagement in treatment.

Scaling up

The SPARK system has been tested in 200 mental health providers and 360 children, and Ruggiero is eagerly awaiting the findings.

“If we find that it had significant impact, we want to scale SPARK and start to build out more platforms so that clinicians have a lot more tools like it in their hands,” said Ruggiero.

Indeed, his focus for TACHL in the coming decade is to take digital interventions it has developed and shown to be effective and scale them up dramatically.

“In the past, TACHL has prioritized knowledge building and discovery with novel interventions,” he said. “That continues to be important for us. But, going forward, I'd like to prioritize population impact much more.”

By scaling up effective, technology-based interventions, he hopes to multiply their impact from helping hundreds of people to hundreds of thousands.

“At the end of my career, I will find it most rewarding if the work our team has done helps to have measurable population impact on traumatic injury patients, for example,” he said. “Right now, 600,000 patients develop PTSD or depression after traumatic injury annually. I hope one day we can look back and say that we helped to reduce that to 400,000.”