With rapidly rising rates of mental health disorders, changing patterns of occurrence, and increasing levels of morbidity, the need for a better understanding of the developmental origins and influence of mental health on children’s behavioral health outcomes has become critical. This need for better understanding extends to both the growing prevalence of mental health disorders as well as the role and impact of neurodevelopmental pathways in their onset and expression. Addressing these changes in disease patterns and effects on children and families will require a multifaceted approach that goes beyond simply making changes to clinical care or adding personnel to the health services system. New policies, financing, and implementation can put established best practices and numerous research findings from around the country into action.
The Maternal and Child Health Life Course Intervention Research Network1 and the Forum for Children’s Well-Being at the National Academies of Sciences, Engineering, and Medicine jointly organized a webinar series to explore how mental health disorders develop over the life course, with a special emphasis on prenatal, early, middle, and later childhood development. This series centered on identifying gaps in our knowledge, exploring possible new strategies for using existing data to enhance understanding of the developmental origins of mental disorders, reviewing potential approaches to prevention and optimization, and proposing new ways of framing how to understand, address, and prevent these disorders from a life course development perspective. The series is a high-level overview
of these topics, and does not include specific information on diagnosing or treating mental health disorders, nor does it explore the full range of mental health disorders that affect children and youth. Organizers hope to use the series to raise awareness about the developmental origins of these alarming mental health trends and offer appropriate strategies to implement effective change.
A series of six virtual webinars was conducted between September 2019 and May 2020 covering various topics related to children’s mental health and the life course model. A detailed listing of all webinar topics and speakers can be found in Appendix A. The first webinar in the series in September 2019 provided an overview that laid out current trends in children’s mental health. Speakers included Neal Halfon, professor of pediatrics, public health, and public policy and director of the UCLA Center for Healthier Children, Families, and Communities, and Kimberly E. Hoagwood, the Cathy and Stephen Graham Professor of Child and Adolescent Psychiatry at New York University’s School of Medicine. For the second webinar in this series in October 2019, Stephen Buka, professor of epidemiology at the Brown University School of Public Health, hosted a discussion about the epidemiology of children’s mental health disorders. The third webinar took place in November and featured a discussion about scientific advances in the developmental origins of children’s mental health disorders led by Pilyoung Kim, director of the Family and Child Neuroscience Lab at the University of Denver. The series continued in February 2020, starting with a multifaceted discussion on comprehensive policy responses to children’s changing mental health needs. This webinar featured Benjamin Miller, chief strategy officer at Well Being Trust, Alex Briscoe, principal at California Children’s Trust, and Nathaniel Counts, assistant director of Montefiore Health System. April’s webinar presented arguments from Laurel Leslie, vice president for research at the American Academy of Pediatrics, and Tom Boat, director of CFWELL at Cincinnati Children’s Hospital Medical Center, and suggested approaches for transforming the pediatric care system. Finally, Erin Dunn, assistant professor at Harvard Medical School and Massachusetts General Hospital, concluded the series in May with a discussion on sensitive periods in development linked to risk for depression and other brain health challenges in children and adolescents.
This proceedings document is organized into seven chapters. Following the introduction with background on the forum’s related work and
organization of the webinar series, Chapter 2 presents an overview that lays out trends in children’s mental health. Chapter 3 describes the developmental origins of children’s mental health disorders, including links between adverse childhood experiences, biological mechanisms of stress pathways, and opportunities for intervention. Chapter 4 provides new ways of thinking about the field, as well as opportunities and challenges for ways to improve health systems. Comprehensive policy responses and solution ideas are offered in Chapter 5, while Chapter 6 describes transformations within pediatric care and Chapter 7 offers potential areas of research based on suggestions by speakers and participants throughout the initiative. Copies of the speaker slides and recordings of the workshop can be viewed on the forum website at https://nationalacademies.org/ccab.
This record of proceedings has been prepared by the workshop rapporteur as a factual summary of what occurred at the workshop. The planning committee’s role was limited to planning and convening the workshop. The views contained in the proceedings are those of individual workshop participants and do not necessarily represent the views of all workshop participants, the planning committee, or the National Academies.
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