"When I was going through postpartum, there was nobody talking about it. I said, you know what — I have to talk. If I don't talk about it, then for the change to happen, we have to be the change."
Sonia Prashar didn't plan to spend 18 years in clinical research. Her PhD professor didn't think she was the right fit for the lab. During a spring break, she was nudged toward a CRA role in urology and oncology — and never looked back.
What kept her? Seeing results firsthand. Not through a microscope, but through conversations with patients and communities. The real-time feedback of watching research make a tangible difference in someone's life became the foundation of her career.
Over time, Sonia moved through dermatology, cardiothoracic procedures, and EP studies before landing in mental health — this time, with deeply personal conviction. After the birth of her children, she experienced postpartum depression herself, compounded by the stigma of discussing mental health within her South Asian community. That experience became a turning point: she returned to research with the intent to break the silence around mental health and push for more pediatric and adult psychiatry studies.
Today, as the founder of AIM Trials, Sonia leads a research site that operates roughly 80% in mental health across pediatric, adult, and geriatric populations. Her team includes board-certified psychiatrists, PhD psychologists, and mental health nurse practitioners — and they're actively working across psychedelic research as well.
Keeping The Patient At The Center Of Psychiatry Research
Sonia is clear about what makes great psychiatry research: keeping the patient at the center and actually connecting with them as a person.
That's easier said than done when you're working in a field where the placebo effect is notoriously strong. In psychiatry, the simple act of building a relationship with a participant — someone living with severe depression or anxiety — can itself contribute to improvement in symptoms. So how do you balance empathy with clinical rigor?
Sonia's answer is nuanced. It's not about removing the human connection — it's about using it to set honest expectations. She described a patient who walked in, read the consent form, and was ready to please the research team. The critical moment was sitting with that person and saying: you're not here to please me. This is for you. If you can't tell me what's really going on, we can't bridge that gap.
It comes down to a thorough informed consent process and understanding where each participant is coming from. Not easy — but someone has to bridge that gap.
How The Mental Health Research Landscape Has Changed
The last decade has reshaped psychiatry research in ways that go far beyond protocol design. Social media has introduced new forms of anxiety for younger populations. COVID changed people's relationship with mental health on a societal level. Marijuana use has increased, raising new questions about eligibility and mitigation. Even the role of oral contraceptives in study protocols has shifted as the research landscape has adapted.
The result: protocols that were manageable 10 years ago are now significantly more complex. The expectations are higher, the guidelines are stricter, and the patient populations are more nuanced.
The Case For Hybrid And Decentralized Trial Design
This is where Sonia gets most passionate — and most specific.
She laid out a concrete example of how a hybrid model could work for a standard MDD study (18–65 years, 3-month duration, ~14 visits):
Visit 1 (on-site): Screening intake, consent, medical history, EKG, blood work, vital signs — roughly 90 minutes.
Visit 2 (remote): The second part of screening is done via telehealth. Rating scales, psych evaluations, and investigator assessments happen over Zoom, reducing the burden of a second multi-hour site visit.
Randomization (on-site): Medication instructions and dispensing logistics are handled in person.
Ongoing visits (hybrid): Medication is shipped via third-party courier with home health visits. Weekly rating scale assessments continue over telehealth. Patient compliance is tracked through third-party apps.
The result, in Sonia's estimation, is a dramatic improvement in retention. Patients don't have to take time off work every week. They don't sit in 40 minutes of traffic before a mood assessment. They're more present, more comfortable, and more likely to give honest, clean data.
She also made a compelling counterargument to the concern that remote data might be "less clean." A patient who just fought traffic for 40 minutes, left work early, and is sitting in a clinic with elevated blood pressure and residual frustration — is that really a cleaner data environment than someone sitting comfortably in their own home on a Zoom call?
Why Diversity Requires Going Beyond Brick-And-Mortar
Sonia pushed hard on a point that's easy to overlook: even if you can fill a study from the population within a 20-mile radius of your site, that doesn't mean the data is representative.
A concentrated catchment area might be saturated with one or two ethnic groups. If you want a medication to work across genetically diverse populations, you have to expand that radius. But you can't expect someone living two hours away in a rural area to drive to a metro clinic every two weeks — especially when they're already dealing with the economic pressures of the current moment.
Sonia shared a powerful proof point: AIM Trials ran a fully decentralized study for Duchenne muscular dystrophy in adolescents. The results were striking — roughly 60% increase in recruitment and 100% retention. Medications were shipped, monitoring was remote via wearable devices, and home health visits replaced clinic trips. That study not only improved accessibility for patients and caregivers but also captured real-time data that wouldn't have been possible in a traditional setting — and it directly informed the development of a follow-up protocol.
She's now working with Canadian healthcare officials to build decentralized trial protocols for rural populations who lack accessible transportation, especially during harsh winters.
Why Research Is Still Behind On Technology Adoption
When asked why research hasn't adopted technology at the pace of other industries, Sonia's answer was direct: it's a lack of knowledge.
She acknowledged the common argument — that research requires stable, consistent conditions over long study durations, making rapid iteration difficult. But her view is that the bigger barrier is fear and unfamiliarity. COVID proved that the industry can adapt quickly when forced to. Business continued. Research resumed. What was missing wasn't willingness — it was the operational knowledge of how to implement new models.
The FDA's January 2025 guidance on AI in research signals regulatory flexibility. But sponsors remain hesitant. Whether it's cost, complexity, or simply inertia, the gap between what's possible and what's being implemented remains wide.
Sonia's message to sponsors: give sites the option. Even if you can't implement hybrid models across an entire protocol, build in flexibility for home health visits and telehealth when a patient is in crisis, when retention is at risk, or when the alternative is losing six months of data to an early termination.
On Building A Research Site — And Staying Resilient
When asked what she wished she knew 10 years ago before starting AIM Trials, Sonia didn't hesitate: she wished she knew how hard it would be.
Starting seemed easy. Actually sustaining it — staying relevant amid competition and noise, keeping ahead of the curve, managing the day-to-day operational grind — is a marathon. And the hardest part isn't the business challenges. It's keeping your own mental health in check while doing it.
She reflected on a conversation with one of her psychiatrists, who told her: the person you were two years ago is not who you are today. People will gossip. People will stay where they are. But if you keep moving forward and learn to forgive yourself for the inevitable mistakes, you keep growing.
Her closing thought was one that resonated deeply: people always ask about the wins. Nobody asks about the failures. And the real lessons — the ones that actually shape you — live in those failures.
