Imperative to accelerate research aligning real-time clinical demand with mental health supply

Zima, Bonnie T.; Devaskar, Sherin U.

doi:10.1038/s41390-022-02246-x

Comment
Published: 14 September 2022

Imperative to accelerate research aligning real-time clinical demand with mental health supply

Bonnie T. Zima ORCID: orcid.org/0000-0002-5542-1879^1,2,3 &
Sherin U. Devaskar^1,2,3
on behalf of the Pediatric Policy COUNCIL

Pediatric Research volume 92, pages 917–920 (2022) Cite this article

971 Accesses
7 Citations
3 Altmetric
Metrics details

In this edition, four studies are broadly related to child mental health. Two studies are dedicated to risk reduction of neurodevelopmental delays,^1,2 one identifies an association between maternal emotionality 2 years post-partum and poor working memory among her first-born child at age 6 years,³ and one explores an association between omega-3 fatty acid supplements and heart rate variability pre- and post-meals among adolescent females with eating disorders.⁴ Together, publication of these studies in Pediatric Research is consistent with long-standing recommendations that prevention, early intervention, and treatment of child mental health disorders is a national priority area.^5,6,7

During the coronavirus disease 2019 (COVID-19) pandemic, the importance for pediatric research to accelerate the alignment between child need for mental health care and supply of services intensified. The pandemic created an unprecedented burden on children and families by increasing the need for mental health care,^8,9,10,11,12 while escalating existing institutional strain^{13,14,15,16,17,18,19} and worsening health care disparities.^{20,21,22,23,24,25,26,27,28} On October 19, 2021, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association together representing >77,000 physician members and >200 children’s hospitals, declared a national state of emergency in child and adolescent mental health.²⁹ The U.S. Surgeon General’s Advisory in 2021 recommended a multi-prong approach to “ensure that every child has access to high-quality, affordable, and culturally competent mental health care”.³⁰ Within the national action plan are recommendations for an integrated, real-time data infrastructure to improve the timeliness of pediatric research, strengthen the capacity to examine trends in child mental health care need and service use across the age continuum, stratify data beyond race to identify disparities, and scale up evidence-based interventions in community settings.³⁰ How do we leverage the early lessons learned from prior research to effectively advocate for the development, maintenance, and sustainability of this visionary data infrastructure?

Data availability

Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.

References

Ish, J. et al. Maternal occupational exposure to chemicals and child cognitive function. Pediatr. Res. https://doi.org/10.1038/s41390-022-02089-6 (2022).
Chock, V. et al. Early brain and abdominal oxygenation in extremely low birth weight infants. Pediatr. Res. https://doi.org/10.1038/s41390-022-02082-z (2022).
Yu, Y., Ma, Q. & Groth, S. W. Association between maternal psychological factors and offspring executive function: analysis of African-American mother-child dyads. Pediatr. Res. https://doi.org/10.1038/s41390-022-02084-x (2022).
Harrison, T., Brown, R., Bonny, A., Manos, B. & Bravender, T. Omega-3 fatty acids and autonomic function in adolescents with anorexia: a randomized trial. Pediatr. Res. https://doi.org/10.1038/s41390-022-02058-z (2022).
The National Advisory Mental Health Council Workgroup on Child and Adolescent Mental Health Intervention Deployment and Development. Blueprint for Change: Research on Child and Adolescent Mental Health (National Advisory Mental Health Council, 2001).
New Freedom Commission on Mental Health. Achieving the promise: transforming mental health care in America. Final report. http://store.samhsa.gov/product/Achieving-the-Promise-Transforming-Mental-Health-Care-in-America-Executive-Summary/SMA03-3831 (2003).
Bartlett, J. D. & Stratford, B. A national agenda for children’s mental health. https://www.childtrends.org/publications/a-national-agenda-for-childrens-mental-health (2022).
Racine, N. et al. Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID-19: a meta-analysis. JAMA Pediatr. 175, 1142–1150 (2021).
Verlenden, J. V. et al. Association of children’s mode of school instruction with child and parent experiences and well-being during the COVID-19 pandemic—COVID experiences Survey, United States, October 8–November 13, 2020. MMWR 70, 369 (2021).
CAS PubMed PubMed Central Google Scholar
Xie, X. et al. Mental health status among children in home confinement during the coronavirus disease 2019 outbreak in Hubei Province, China. JAMA Pediatr. 174, 898–900 (2020).
Penner, F., Ortiz, J. H. & Sharp, C. Change in youth mental health during the COVID-19 pandemic in a majority Hispanic/Latinx US sample. J. Am. Acad. Child Adolesc. Psychiatry 60, 513–523 (2021).
Article Google Scholar
Singh, S. et al. Impact of COVID-19 and lockdown on mental health of children and adolescents: a narrative review with recommendations. Psychiatry Res. 293, 113429 (2020).
Hoagwood, K. E. & Kelleher, K. J. A Marshall Plan for children’s mental health after COVID-19. Psychiatr. Serv. 71, 1216–1217 (2020).
Article Google Scholar
Pinals, D. A., Hepburn, B., Parks, J. & Stephenson, A. H. The behavioral health system and its response to COVID-19: a snapshot perspective. Psychiatr. Serv. 71, 1070–1074 (2020).
Article Google Scholar
Whitney, D. G. & Peterson, M. D. US national and state-level prevalence of mental health disorders and disparities of mental health care use in children. JAMA Pediatr. 173, 389–391 (2019).
Article Google Scholar
Coker, T. R. et al. Racial and ethnic disparities in ADHD diagnosis and treatment. Pediatrics 138, e20160407 (2016).
Article Google Scholar
Zima, B. T. et al. Quality of care for childhood attention-deficit/hyperactivity disorder in a managed care Medicaid program. J. Am. Acad. Child Adolesc. Psychiatry 49, 1225–1237. e1211 (2010).
PubMed PubMed Central Google Scholar
Epstein, J. N. et al. Variability in ADHD care in community-based pediatrics. Pediatrics 134, 1136–1143 (2014).
Danielson, M. L. et al. Prevalence of parent-reported ADHD diagnosis and associated treatment among US children and adolescents, 2016. J. Clin. Child Adolesc. Psychol. 47, 199–212 (2018).
Article Google Scholar
Shim, R. S. & Starks, S. M. COVID-19, structural racism, and mental health inequities: policy implications for an emerging syndemic. Psychiatr. Serv. 72, 1193–1198 (2021).
Bernardini, F., Attademo, L., Rotter, M. & Compton, M. T. Social determinants of mental health as mediators and moderators of the mental health impacts of the COVID-19 pandemic. Psychiatr. Serv. 72, 598–601 (2021).
Article Google Scholar
Purtle, J., Nelson, K. L., Bruns, E. J. & Hoagwood, K. E. Dissemination strategies to accelerate the policy impact of children’s mental health services research. Psychiatr. Serv. 71, 1170–1178 (2020).
Article Google Scholar
Lopez, L., Hart, L. H. & Katz, M. H. Racial and ethnic health disparities related to COVID-19. JAMA 325, 719–720 (2021).
Article CAS Google Scholar
Dooley, D. G., Bandealy, A. & Tschudy, M. M. Low-income children and coronavirus disease 2019 (COVID-19) in the US. JAMA Pediatr. 174, 922–923 (2020).
Article Google Scholar
Williams, D. R. & Cooper, L. A. COVID-19 and health equity—a new kind of “herd immunity”. JAMA 323, 2478–2480 (2020).
Article CAS Google Scholar
Berwick, D. Choices for the “new normal”. JAMA 323, 2125–2126 (2020).
Article CAS Google Scholar
Graves, J. M., Mackelprang, J. L. & Abshire, D. A. Coronavirus disease 2019 and effects of school closure for children and their families. JAMA Pediatr. 175, 210–211 (2020).
Fritz, C. Q. et al. Child Opportunity Index and changes in pediatric acute care utilization in the COVID-19 pandemic. Pediatrics 149, e2021053706 (2022).
American Academy of Child & Adolescent Psychiatry. Pediatricians, child and adolescent psychiatrists and children’s hospitals declare national emergency in children’s mental health. https://www.aacap.org/AACAP/zLatest_News/Pediatricians_CAPs_Childrens_Hospitals_Declare_National_Emergency_Childrens_Mental_Health.aspx (2021).
The U.S. Surgeon General’s Advisory. Protecting youth mental health. https://www.hhs.gov/sites/default/files/surgeon-general-youth-mental-health-advisory.pdf (2021).
Hamoda, H. M. et al. Addressing the consequences of the COVID-19 lockdown for children’s mental health: investing in school mental health programs. Psychiatr. Serv. 72, 729–731 (2021).
Loades, M. E. et al. Rapid systematic review: the impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. J. Am. Acad. Child Adolesc. Psychiatry 59, 1218.e3–1239.e3 (2020).
Golberstein, E., Wen, H. & Miller, B. F. Coronavirus disease 2019 (COVID-19) and mental health for children and adolescents. JAMA Pediatr. 174, 819–820 (2020).
Article Google Scholar
Lee, J. Mental health effects of school closures during COVID-19. Lancet Child Adolesc. Health 4, 421 (2020).
Article CAS Google Scholar
Esposito, S. & Principi, N. School closure during the coronavirus disease 2019 (COVID-19) pandemic: an effective intervention at the global level? JAMA Pediatr. 174, 921–922 (2020).
Guessoum, S. B. et al. Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown. Psychiatry Res. 291, 113264 (2020).
Constantino, J. N., Sahin, M., Piven, J., Rodgers, R. & Tschida, J. The impact of COVID-19 on individuals with intellectual and developmental disabilities: clinical and scientific priorities. Am. J. Psychiatry 177, 1091–1093 (2020).
Article Google Scholar
Baron, E. J., Goldstein, E. G. & Wallace, C. T. Suffering in silence: How COVID-19 school closures inhibit the reporting of child maltreatment. J. Public Econ. 190, 104258 (2020).
Article Google Scholar
Ortiz, R. et al. Assessing child abuse hotline inquiries in the wake of CoViD-19: answering the call. JAMA Pediatr. 175, 859–861 (2021).
Rosenthal, C. M. & Thompson, L. A. Child abuse awareness month during the coronavirus disease 2019 pandemic. JAMA Pediatr. 174, 812 (2020).
Humphreys, K. L., Myint, M. T. & Zeanah, C. H. Increased risk for family violence during the COVID-19 pandemic. Pediatrics 145, e20200982 (2020).
Article Google Scholar
Greeley, C. Child maltreatment prevention in the era of coronavirus disease 2019. JAMA Pediatr. 174, e202776 (2020).
Article Google Scholar
Hillis, S. D. et al. Global minimum estimates of children affected by COVID-19-associated orphanhood and deaths of caregivers: a modelling study. Lancet 398, 391–402 (2021).
Kidman, R., Margolis, R., Smith-Greenaway, E. & Verdery, A. M. Estimates and projections of COVID-19 and parental feath in the US. JAMA Pediatr. 175, 745–746 (2021).
Gassman-Pines, A., Ananat, E. O. & Fitz-Henley, J. COVID-19 and parent-child psychological well-being. Pediatrics 146, e2020007294 (2020).
Patrick, S. W. et al. Well-being of parents and children during the COVID-19 pandemic: a national survey. Pediatrics 146, e2020016824 (2020).
Marti, F. A., Pourat, N., Lee, C. & Zima, B. T. Overview of ten child mental health clinical outcome measures: testing of psychometric properties with diverse client populations in the US. Adm. Policy Ment. Health 49, 197–225 (2022).
Article Google Scholar
National Institute of Health. Adolescent Brain Cognitive Development Study. https://abcdstudy.org/ (2022).
Cohen, S., Kamarck, T. & Mermelstein, R. A global measure of perceived stress. J. Health Soc. Behav. 24, 385–396 (1983).
Salsman, J. M. et al. Emotion assessment using the NIH Toolbox. Neurology 80, S76–S86 (2013).
Article Google Scholar
National Institute of Mental Health. NIH Toolbox Sadness Fixed Form Ages 8-17 v2.0. https://www.healthmeasures.net/index.php?option=com_instruments&view=measure&id=693 (2022).
Xiao, Y., Yip, P. S. F., Pathak, J. & Mann, J. J. Association of social determinants of health and vaccinations with child mental health during the COVID-19 pandemic in the US. JAMA Psychiatry 79, 610–621 (2022).
Data Resource Center for Child and Adolescent Health. National survey of child health. https://www.childhealthdata.org/learn-about-the-nsch/NSCH (2022).
Lebrun-Harris, L. A., Ghandour, R. M., Kogan, M. D. & Warren, M. D. Five-year trends in US children’s health and well-being, 2016-2020. JAMA Pediatr. 176, e220056 (2022).
Data Resource Center for Child and Adolescent Health. Full-length NSCH survey instruments. https://www.census.gov/content/dam/Census/programs-surveys/nsch/tech-documentation/questionnaires/2020/NSCH-T3.pdf (2022).
Joint Commission. Detecting and treating suicide ideation in all settings. Sentinel Event Alert 1–7 (2016).
Hill, R. M. et al. Suicide ideation and attempts in a pediatric emergency department before and during COVID-19. Pediatrics 147, e2020029280 (2021).
Davis, M. et al. Identifying adolescent suicide risk via depression screening in pediatric primary care: an electronic health record review. Psychiatr. Serv. 72, 163–168 (2021).
Article Google Scholar
Mayne, S. L. et al. COVID-19 and adolescent depression and suicide risk screening outcomes. Pediatrics 148, e2021051507 (2021).
Leeb, R. T. et al. Mental health–related emergency department visits among children aged< 18 years during the COVID-19 pandemic—United States, January 1–October 17, 2020. MMWR 69, 1675 (2020).
CAS PubMed PubMed Central Google Scholar
Yard, E. et al. Emergency department visits for suspected suicide attempts among persons aged 12–25 years before and during the COVID-19 pandemic—United States, January 2019–May 2021. MMWR 70, 888 (2021).
CAS PubMed PubMed Central Google Scholar
Pelletier, J. H. et al. Trends in US pediatric hospital admissions in 2020 compared with the decade before the COVID-19 pandemic. JAMA Netw. Open 4, e2037227 (2021).
Article Google Scholar
DeLaroche, A. M. et al. Pediatric emergency department visits at US children’s hospitals during the COVID-19 pandemic. Pediatrics. 147, e2020039628 (2021).
Zima, B. T. et al. Classification system for International Classification of Diseases, Ninth Revision, Clinical Modification and Tenth Revision Pediatric Mental Health Disorders. JAMA Pediatr. 174, 620–622 (2020).
U.S. Department of Education. Individuals with Disabilities Education Act: Sec. 300.8 Child with a disability. https://sites.ed.gov/idea/regs/b/a/300.8 (2021).
Zima, B. T. et al. Use of acute mental health care in US children’s hospitals before and after statewide COVID-19 school closure orders. Psychiatr. Serv. https://doi.org/10.1176/appi.ps.202100582 (2022).
Burkhart, K., Asogwa, K., Muzaffar, N. & Gabriel, M. Pediatric integrated care models: a systematic review. Clin. Pediatr. 59, 148–153 (2020).
Article Google Scholar
Hoover, S. A. et al. Advancing Comprehensive School Mental Health Systems: Guidance from the Field (National Center for School Mental Health, University of Maryland, 2019).
Cummings, J. R., Wilk, A. S. & Connors, E. H. Addressing the child mental health state of emergency in schools—opportunities for state policy makers. JAMA Pediatr. 176, 541–542 (2022).
Wright, J. L. et al. Achieving equity through science and integrity: dismantling race-based medicine. Pediatr. Res. 91, 1641–1644 (2022).

Download references

Author information

Authors and Affiliations

Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
Bonnie T. Zima & Sherin U. Devaskar
Department of Pediatrics, University of California at Los Angeles, Los Angeles, CA, USA
Bonnie T. Zima & Sherin U. Devaskar
Pediatric Policy Council, Washington, DC, USA
Bonnie T. Zima, Sherin U. Devaskar, Shetal Shah, Mona Patel, Jean Raphael, DeWayne Pursley, David Keller, Tina Cheng, Joyce Javier & Lois Lee

Authors

Bonnie T. Zima
View author publications
Search author on:PubMed Google Scholar
Sherin U. Devaskar
View author publications
Search author on:PubMed Google Scholar

Consortia

on behalf of the Pediatric Policy COUNCIL

Shetal Shah
, Mona Patel
, Jean Raphael
, DeWayne Pursley
, David Keller
, Sherin U. Devaskar
, Tina Cheng
, Joyce Javier
& Lois Lee

Contributions

B.T.Z. developed the conceptual framework, conducted a systematic literature review, drafted the first full draft, completed multiple revisions, and approved final version. S.U.D. provided guidance on the concept for the commentary, provided comments on earlier manuscript drafts to critically revise important intellectual content, coordinated gathering feedback from the Pediatric Policy Council, and approved final version.

Corresponding author

Correspondence to Bonnie T. Zima.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zima, B.T., Devaskar, S.U. & on behalf of the Pediatric Policy COUNCIL. Imperative to accelerate research aligning real-time clinical demand with mental health supply. Pediatr Res 92, 917–920 (2022). https://doi.org/10.1038/s41390-022-02246-x

Download citation

Received: 21 June 2022
Revised: 29 June 2022
Accepted: 19 July 2022
Published: 14 September 2022
Version of record: 14 September 2022
Issue date: October 2022
DOI: https://doi.org/10.1038/s41390-022-02246-x

Imperative to accelerate research aligning real-time clinical demand with mental health supply

Log in or create a free account to read this content

Data availability

References

Author information

Authors and Affiliations

Consortia

on behalf of the Pediatric Policy COUNCIL

Contributions

Corresponding author

Ethics declarations

Competing interests

Additional information

Rights and permissions

About this article

Cite this article

Search

Quick links

Log in or create a free account to read this content

Data availability

References

Author information

Authors and Affiliations

Consortia

on behalf of the Pediatric Policy COUNCIL

Contributions

Corresponding author

Ethics declarations

Competing interests

Additional information

Rights and permissions

About this article

Cite this article

Share this article

Search

Quick links