Yael Dvir ^1* Ujjwal Ramtekkar ²

• ¹ Psychiatry/Child and Adolescent Psychiatry, University of Massachusetts Medical School, Worcester, MA, United States
• ² School of Medicine, University of Missouri, Columbia, United States

We are pleased to introduce Fron7ers Research Topic -Rising Stars in Child Mental Health and Interven7ons. This collec2on of ar2cles includes 12 original papers authored by 81 authors and an inten2onally broad array of topics highly relevant to the field of child and adolescent psychiatry. It is no secret that children and adolescents' mental health and wellbeing have received significant public aAen2on in recent years, following documented increases in depression, anxiety, and neurodevelopmental disorders. As ar2culated in the US Surgeon General Advisory on protec2ng youth mental health, the COVID-19 pandemic enhanced youth's pre-exis2ng challenges and increasing rates of psychological distress, especially in already vulnerable popula2ons. The advisory concluded that maintaining health children and families requires all of society to take part in this effort. 1 The United Na2ons unicef and the World Health Organiza2on have also highlighted youth mental health as a global challenge, which affects young people in every part of the world, causing significant suffering. 2,3 As such, we are encouraged that the themes of this research topic suggest that new and exci2ng opportuni2es to improve children and adolescents' mental health are occurring in many seTng where youth are cared for, and that enhancing the scien2fic knowledge in mental health and allied fields is a priority. We would like to reflect on some of the themes that emerged for us while edi2ng this topic.Children and adolescent spend many hours in school and educa2onal environments, and educators and other professional staff at school are important in no2cing and repor2ng on any concerns in both typically developing youth and those with diagnosed developmental or behavioral health condi2ons. Using educa2onal seTngs to assess social skills and predict depression has been an important component of the work of Krygsman and colleagues who report on depression symptoms, communica7on and coopera7on skills, and friendship: longitudinal associa7ons in young Norwegian children. Their findings suggest a rela2onship between depressive symptoms in preschool, the development of early social skills and friendships, and later childhood depression. In a study delivering an interven2on in an elementary school seTng, Leger-Goodes and colleagues describe feasibility, acceptability, and perceived benefits of a crea7ve arts interven7on for elementary school children living with speech, language and communica7on disorders. Their pilot work suggests acceptability of this model by educa2onal teams as well as poten2al benefits for student's emo2onal expression.While the evidence base for psychotherapeu2c approaches to youth's behavioral health challenges are expanding, one challenge for prac2cing clinicians is that most of these interven2ons are studied in academic seTngs. Therefore, the work done by the two following groups of researchers adap2ng and tes2ng treatment protocols to and in diverse seTngs, interna2onally or in correc2onal seTngs, are highly important in bridging these gaps. Dozio and colleagues reported on comparing the effec7veness of narra7ve therapy and EMDR-GTEP protocols in the treatment of post-trauma7c stress in children exposed to humanitarian crises. Their study which was conducted with children in the Central African Republic suggests that both protocols are effec2ve in reducing symptoms of trauma2c exposure and can be conducted by trained paraprofessionals. Given that many parts of the world are currently experiencing humanitarian crises situa2ons for various reasons, this is a highly relevant study. Similarly, while dialec2cal behavioral therapy has a significant evidence base for the treatment of emo2onal dysregula2on in adolescents with several mental health diagnosis, it has not been shown to be effec2ve or feasible in correc2onal seTngs. Folk and colleagues have shown in their pilot study that comprehensive dialec7cal behavior therapy for adolescents in a juvenile correc7onal treatment center is a promising interven2on that can be implemented with success.Smith and colleagues are offering an important contribu2on to the evidence-based approaches to serious mental illness in youth, repor2ng on alterna7ve psychopharmacologic treatments for pediatric catatonia: a retrospec7ve analysis.Several studies included in this collec2on provide insights into how tailored interven2ons can reduce anxiety, stress, emo2onal dysregula2on, and other mental health issues among youth and their caregivers.Caregivers play a central role in managing the mental health of anxious children, and recent studies emphasize the need to support caregivers' well-being alongside that of their children. RaZery-Helmer and colleagues highlight the effec7veness of Acceptance and Commitment Therapy for Parents of Anxious Children (ACT-PAC), which reduces caregivers' stress and cogni2ve challenges linked to child anxiety. By addressing these caregiver-specific issues, the study shows improvements in both caregiver mental health and child anxiety, underscoring the interconnectedness of their well-being.Similarly, Huffman and colleagues found that when children undergo digital mental health interven7ons (DMHIs) such as behavioral coaching and therapy, caregivers also experience significant benefits. Caregivers reported improvements in sleep and reduced stress levels, demonstra2ng that addressing children's mental health has posi2ve effects for the en2re family, emphasizing the value of family-centered mental health care that includes caregivers in the therapeu2c process.As climate change becomes an increasing concern, studies are beginning to focus on the mental health impacts of ecological issues, par2cularly among young people. Malboeuf-Hurtubise and colleagues explore the growing phenomenon of eco-anxiety in youth, showing that posi7ve psychology interven7ons can help mi2gate feelings of hopelessness by fostering resilience, hope, and meaning-making. By encouraging young people to transform their anxiety into proac2ve engagement with environmental issues, this approach offers an innova2ve way to support youth mental health in the face of global challenges.Maternal health, par2cularly during pregnancy and early childhood, has a profound impact on the long-term mental health of children. Jalnapurkar and colleagues emphasize that maternal physical and mental health condi2ons, as well psychosocial challenges, are linked to higher rates of anxiety and depression in extremely low gesta7onal age newborns aRer 15 years. Their findings highlight the importance of early interven2ons aimed at improving maternal health, which in turn can significantly reduce the risk of psychiatric disorders in their children. This research underscores the need for preven2ve mental health strategies that extend beyond the child to include maternal and early-life factors.When it comes to managing emo2onal dysregula2on and ADHD in children, mul2dimensional interven2ons are showing promising results. Vilagomez and colleagues inves2gate the role of broad-spectrum micronutrients (BSMs) in improving emo7onal regula7on in psychiatric condi2ons like ADHD and mood disorders. Their research suggests that BSMs offer a complementary approach to tradi2onal psychiatric treatments, contribu2ng to more effec2ve emo2onal management. In another study, Lou and colleagues explored the combina2on of behavior modifica7on training and EEG biofeedback to treat children with ADHD. Their research demonstrated significant improvements in core symptoms such as hyperac2vity, impulsivity, and inaAen2on, par2cularly when both methods were used together. This comprehensive approach, integra2ng behavioral and neurological interven2ons, highlights the poten2al of mul2-modal treatments for managing complex psychiatric condi2ons like ADHD.The findings from these studies highlight the need for holis2c, mul2dimensional approaches to mental health care while considering the well-being of both children and caregivers.