Hospital-based clinicians have been in the trenches of the behavioral health crisis affecting children well before the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association jointly declared a National State of Emergency in Children’s Mental Health in October 2021.1 Physicians, nurses, and other allied health specialists cared for children and adolescents in crisis in emergency departments and hospital floors that were not designed for mental health care and often with limited and ad hoc education training. Additionally, most pediatric hospital medicine providers have limited and ad hoc education and training in behavioral and mental health care. Increasingly, though, we have observed with pride pediatric hospital medicine and emergency medicine physicians and researchers designing and testing interventions to improve care and generate new knowledge to better treat this large and growing group of patients.
One year ago, we announced this month’s special issue in Hospital Pediatrics coinciding with May’s Mental Health Awareness month to underscore the continued crisis and to share the efforts by so many in our community.2 We are thrilled with how our community heeded the call to action with dedicated scholarly efforts and evidence-based interventions to mitigate the effects on children and families in the hospital setting.
The articles in this issue highlight critical areas along the spectrum of mental health issues: identification of firearm access in children with mental health complaints,3 inequitable physical restraint use in Children’s Hospitals,4 how to measure the quality of care for pediatric agitation with attention to accountability and equity,5,6 impact of the coronavirus disease 2019 pandemic on hospitalizations for suicidality and intentional ingestions,7,8 outcomes for young adults with suicide attempts admitted to adult versus pediatric hospitals,9 and improved inpatient suicide screening.10 Investigators report on interventions in areas such as youth experiencing psychiatric boarding,10 share opportunities to better understand factors that prolong hospitalization,11 and offer recommendations on how to holistically serve hospitalized children with autism.12 Importantly in this issue, we share the work of investigators bringing attention to the wellbeing and safety of clinicians and hospital employees at the front lines.13,14 This issue also features several important perspectives from pediatric hospitalists reflecting on different challenges of practicing medicine12,15,16 as well our field’s continued focus on value and the difficulties we have practicing high-value care for children with medical and behavioral complexity.17
We hope that this special issue and future articles contribute to increasing knowledge and urgency regarding the mental health crisis and inspire our readership and trainees to join the cause. There remains much work to be done, and we will continue to bring focus on this at Hospital Pediatrics.
Dr Loyal drafted the initial manuscript; and Drs Loyal, Brady, and Russell conceptualized the editorial, reviewed and revised the editorial, and approved the final editorial as submitted.
FUNDING: No external funding.
CONFLICT OF INTEREST DISCLOSURES: The authors have indicated they have no conflicts of interest to disclose.
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