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.

1
American Academy of Pediatrics
. AAP-AACAP-CHA declaration of a national emergency in child and adolescent mental health. AAP.org. https://www.aap.org/en/advocacy/child-and-adolescent-healthy-mental-development/aap-aacap-cha-declaration-of-a-national-emergency-in-child-and-adolescent-mental-health/. Accessed February 26, 2024
2
Substance Abuse and Mental Health Services Administration
. Mental health awareness month. Available at: https://www.samhsa.gov/mental-health-awareness-month. Accessed February 26, 2024
3
Uspal
NG
, et al
.
Improving identification of firearm access in children with mental health complaints
.
Hosp Pediatr
.
2024
;
14
(
5
):
e2023007451
4
Luccarelli
J
, et al
.
Pediatric physical restraint coding in US hospitals: a 2019 Kids Inpatient Database study
.
Hosp Pediatr
.
2024
;
14
(
5
):
e2023007562
5
Hoffman
JA
, et al
.
Use of electronic health record-based measures to assess quality of care for pediatric agitation
.
Hosp Pediatr
.
2024
;
14
(
5
):
e2023007532
6
Nash
KA
, et al
.
Accountability to quality of care for children with acute agitation in the emergency department
.
Hosp Pediatr
.
2024
;
14
(
5
):
e2024007776
7
Vepraskas
SH
, et al
.
Impact of COVID-19 on acute care hospitalizations for suicidality
.
Hosp Pediatr
.
2024
;
14
(
5
):
e2023007666
8
Kane
JM
, et al
.
COVID-19 and intentional toxic pediatric acetaminophen ingestions, a research brief
.
Hosp Pediatr
.
2024
;
14
(
5
):
e2023007424
9
Jacobson
EL
, et al
.
Outcomes for young adults with suicide admitted to adult versus pediatric hospitals
.
Hosp Pediatr
.
2024
;
14
(
5
):
e2023007691
10
House
SA
, et al
.
Human-centered design to improve care for youths experiencing psychiatric boarding
.
Hosp Pediatr
.
2024
;
14
(
5
):
e2023007688
11
DePorre
AG
, et al
.
Factors associated with prolonged mental health admissions at US children’s hospitals
.
Hosp Pediatr
.
2024
;
14
(
5
):
e2023007684
12
Klinepeter
E
, et al
.
The disposition dilemma: delivering holistic care for youths with autism in an acute care hospital
.
Hosp Pediatr
.
2024
;
14
(
5
):
e2023007685
13
Laprime
A
, et al
.
Improving employee safety through a comprehensive behavioral program at a children’s hospital
.
Hosp Pediatr
.
2024
;
14
(
5
):
e2023007714
14
Slovin
A
, et al
.
Meaningful work, career fit, and professional well-being of pediatric academicians in the U.S
.
Hosp Pediatr
.
2024
;
14
(
5
):
e2022007080
15
Mou
M
.
It’s OK: take a break
.
Hosp Pediatr
.
2024
;
14
(
5
):
e2023007689
16
Dean
A
.
This is PHM: a lesson in mindfulness from global health for the mental health crisis
.
Hosp Pediatr
.
2024
;
14
(
5
):
e2023007611
17
Yankova
L
, et al
.
Low-value care for hospitalized children with dual medical and behavioral complexity
.
Hosp Pediatr
.
2024
;
14
(
5
):
e2024007766

Competing Interests

CONFLICT OF INTEREST DISCLOSURES: The authors have indicated they have no conflicts of interest to disclose.