NCAPA recently sat down with Martha “Marty” Nelson, MHS, PA-C, who serves a unique role as a physician assistant (PA). In addition to practicing at Duke University’s Healthy Lifestyles clinic since 2008, PA Nelson is also a REACH PPP trainer for the NC Psychiatry Access Line (NC-PAL).
Originally from Mississippi, Marty was a Registered Nurse (RN) and former Peace Corps volunteer before moving to North Carolina for PA school. She graduated from the Duke University PA Program in 2002.
“For my undergraduate degree, I went to the University of South Alabama in Mobile, Alabama. It was one of the early programs that offered a BS in Nursing, and that caught my eye, because pursuing health equity has always been such an important thing to me. It’s been a lens I’ve looked through, and it reflects a lot of my upbringing.”

As an RN, Nelson practiced in pediatric settings, from the Pediatric ICU to the Pediatric Emergency Room, where she had come to work with PAs. “In the pediatric emergency room, I worked with PAs and I admired the role they played. This was twenty-six years ago. In talking with them, I admired the flexibility of the PA role, and I realized I wanted to pursue the medical model. Fun fact: there were actually four former RNs in my graduating PA class as well.”
Now, she is a PA at Duke’s Healthy Lifestyles clinic, which provides evidence-based evaluation and treatment for obesity and its health complications to children, teens, young adults and their families. PA Nelson shared a peek into her day. “At the Healthy Lifestyles clinic, our multi-disciplinary team partners with the child’s primary care provider to provide support and guidance surrounding nutrition, activity, sleep, and evidenced-based interventions. We also manage co-morbidities that may be associated with or exacerbated by an elevated BMI such as hypertension, diabetes, sleep apnea, asthma, and mental health concerns.”
“Starting in 2019, I noticed that I was seeing more and more children with significant symptoms of anxiety and depression. They were as young as nine with increasing concerns in the teenagers,” she explained. “I wanted to learn how to better manage these patients, aside from referring them out to child psychiatrists, where it could be months before these patients could be seen.”
This motivated PA Nelson to pursue additional resources available. She found NC-PAL, which offers the REACH PPP course – North Carolina’s implementation of the REACH Institute’s Patient-Centered Mental Health in Pediatric Primary Care Program. The REACH Institute is a 501c3 non-profit organization dedicated to ensuring that the most effective, scientifically proven mental health care reaches all children and families.
“I went to my first REACH PPP training session offered by NC-PAL in 2020, and they have a goal of empowering MDs, NPs, PAs, and DOs to take care of children who present to primary care clinics with mental and behavioral health concerns,” Marty said.
NC-PAL’s REACH PPP training is geared towards pediatric primary care providers in North Carolina who prescribe, treat, and diagnose. NC-PAL is a collaboration between the NC Department of Health and Human Services, and the Duke University and UNC Chapel Hill Schools of Medicine. Click here to learn more and register for their upcoming REACH PPP trainings.
After the training, PA Nelson said it had completely transformed her care. “It was fascinating. It totally changed my practice. I was able to expand my knowledge of assessment, medications, counseling, and follow-up, which resulted in fewer referrals and increased access to mental health care for these patients.”
Marty gave us a glimpse into the virtual training from an attendee’s standpoint. “You start on a Friday afternoon and discuss the evidence behind the tools that you are about to obtain. Then, all day Saturday, you take a deep dive into evidence-based medicine surrounding anxiety, depression, and ADHD. Sunday, you spend time discussing additional mental health concerns that may present in your office and how to manage. The really special thing? Normally, a virtual REACH PPP training through the REACH institute costs $1,900. However, as part of NC-PAL’s programming, they are able to facilitate this training for North Carolinians at no cost.”
PA Nelson was so inspired and motivated by her impactful experience as a past participant, that she took the steps to become a REACH trainer herself. She has been a REACH trainer now for three years.
Her most significant takeaway? “I found that I was able to really assess children who presented with depression and have a history of suicidal ideation. I felt that my care got significantly better – I received training on creating safety plans and prescribing SSRIs. I felt confident in my abilities to do so.”
NC-PAL’s telephone consult line has been another tool that PA Nelson has used in her care. “To be clear,” she explained. “The consult line is not a crisis line. It’s a child and adolescent social workers and psychiatrists on the line who walk you through any questions and provides support. Immediately after participating in the REACH training, I would call and ask questions to the consult line, which is a beneficial resource I encourage every provider in North Carolina who cares for children and adolescents to look into.”
NC-PAL’s telephone consultation line is offered to providers looking for a pediatric or perinatal mental health consultation. Behavioral health experts respond to questions about resources, diagnosis, and treatment. It is not an emergency line. The number for the access line is: (919)-681-2909.
The bottom line? “If you are a family practice, pediatrics, or primary care provider in North Carolina and you treat children, adolescents, and young adults, check out the NC-PAL website!” Marty encouraged. “There, you can sign up for a REACH PPP training, explore the Lunch & Learns focused on pediatric mental health, find tools and guides to care for these children, and a plethora of additional resources.”
In her spare time, PA Nelson enjoys gardening and spending time outside with her family. And, if she weren’t a PA, what would she be doing instead? “I would be a full-time gardener who specializes in native plants! I love being outside in the sunshine, and I love concrete results, I love putting something in the dirt, watering it, nurturing it, and watching it grow.”
“The most valuable thing about this course was the instructors! They were so knowledgeable and approachable with questions, while also making the content so engaging. The content was wonderful (ie: learning all of the different types of screening tools and GPS tool), but the BEST thing about this training were the instructors leading it.” -Past REACH PPP provided by NC-PAL participant, Lauren Givens, PA-C