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| EDITORIAL |
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| Year : 2022 | Volume
: 4
| Issue : 2 | Page : 51-53 |
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Child Mental Health and Social Psychiatry – Global and Local Perspectives
Andres Julio Pumariega1, Eugenio Rothe2, Rama Rao Gogineni3
1 Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of Florida College of Medicine, Gainesville, USA
2 Department of Psychiatry, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
3 Department of Psychiatry, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| Date of Submission | 29-Jun-2022 |
| Date of Decision | 29-Jun-2022 |
| Date of Acceptance | 30-Jun-2022 |
| Date of Web Publication | 22-Aug-2022 |
Correspondence Address:
Dr. Andres Julio Pumariega
Child and Adolescent Psychiatry Clinic, UF Health, 8491 N.W. 39th Avenue, Gainesville, Florida 32606
USA
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/wsp.wsp_27_22
How to cite this article:
Pumariega AJ, Rothe E, Gogineni RR. Child Mental Health and Social Psychiatry – Global and Local Perspectives. World Soc Psychiatry 2022;4:51-3 |
Child and adolescent psychiatry as well as child mental health in general are relatively new disciplines within health care from a historical perspective. Although there were some early efforts to provide care for children with mental health needs by faith-based and charitable organizations as well as observant and benevolent lay advocates, formal clinical work with children and youth did not really begin until early in the 20th century, with the writings of Maudsley on childhood insanity, Anna Freud on child psychotherapy, and the clinical observations provided by Kanner around what we know today as autism spectrum disorders.[1] It was not until the 1960s that we actually had clinical trials of pharmacotherapy, beginning with ADHD by John Werry.[1] However, what began as niche specialty services have now rapidly expanded, not only in Western nations but also globally. A rising level of need for mental health services among children and youth are increasingly recognized, now seen as nearing epidemic levels. The driving forces behind such explosion in need in recent years have been primarily psychosocial stressors related to social determinants such as poverty/famine, war, refugee displacement, discrimination and racial/ethnic disparities, and lack of support for families in their child-rearing roles.[2],[3] In addition, as pointed out by Chachar and Mian,[3] children's mental health needs are gaining greater attention in salience as the more basic needs of food/shelter/security are addressed in developing nations.
Three recent developments have promoted the development and expansion of children's mental health services globally. These have included: (1) The developing science and research evidence around child development, diagnostic identification, and therapeutics, that all ultimately support a biopsychosocial approach. (2) The dissemination of specialized training and services for children and youth, first in Western nations but now going beyond to many regions of the globe. (3) At the same time, with increased global development we have witnessed higher levels of adverse social determinants increasing the risk for mental illnesses affecting children and youth and resulting in many adverse outcomes (suicide, traumatic stress, and increasing rates of developmental disorders).
All along its short history, the theory, science, and practice of child and adolescent mental health have had a strong emphasis on the “social”– from the many theorists (Piaget, Montessori, Mead, Vygotsky, and Erickson) who linked culture to normal psychosocial and psychological development[4] to the new science of epigenetics that indicates the biological impact of adverse social determinants through genetic mutations,[5] to the increasing evidence of how cultural transitions and stressors can adversely impact on children's mental health.[6],[7],[8] We have also recognized from early on how family and community strengths and supports are essential components of the healing environment for effective treatment and have incorporated those in some of our most advanced treatment models, such as community systems of care.[9],[10]
This issue of the World Social Psychiatry highlights the impact of social determinants and social context in many areas of children's mental health, and across many national and regional contexts:
- The adverse impact of social determinants on the mental health of children as exemplified by the review article on poverty/hunger/homelessness,[11] the impact of war in Ukraine,[12] the chronic refugee existence under occupation in Palestine,[13] the loss of parents and caregivers in the COVID pandemic,[14] and the increasing pressure of urbanization in developing nations such as Turkey[15]
- Special challenges associated with social, mental health, and medical adversities, ranging from the ongoing challenge of addressing trauma in children and youth,[16] the impact of increasing adolescent social isolation and its relationship to the psychosocial construct of anomie,[17] the psychosocial impact from (and improvement from correction) with eye conditions in children,[18] and the factors contributing to the increasing trend of adolescent mass shooters[19]
- The use of systematic clinical approaches and tools to assist with risk identification, leveraging limited services through consultative service and addressing psychosocial service needs for children in different national and service system contexts, such as the use of systematic suicide screening for adolescents in health-care settings,[20] provision of collaborative care through primary care – child psychiatry consultation,[21] and the use of level of care intensity tools to assist services planning in Belgium and Japan[22],[23]
- The special responsibility of child and adolescent psychiatrists and child mental health professionals to serve as advocates for children facing abuses on the parts of governments and their agents in the process of immigration,[24] as a result of military occupation,[13] as a result of active warfare,[12] and as advocates for children's mental health services, and supports in developing nations.[3]
These articles are only some examples of the work that child mental health professionals and investigators do globally on a daily basis. By presenting this special issue, we wish to place the agenda of child and family mental health front and center in social psychiatry, and the agenda of addressing adverse social determinants before policymakers globally. Addressing adverse social determinants of mental health is perhaps the most effective approach to child mental health and developmental prevention.
We also wish to thank the World Social Psychiatry (WSP), particularly its Chief Editor Dr. Debasish Basu and Co-Editor Dr. Nitin Gupta, and the leadership of the World Association of Social Psychiatry (WASP), for all their encouragement and active support in making this special issue possible. We also are indebted in gratitude to all the authors who responded to this special call for articles in very short notice and with high relevance and quality. This issue was conceptualized as a special project of the child and adolescent mental health group of WASP early this year, and we hope that it reaffirms the role of child adolescent mental health within WASP, as well as WSP serving as a home for many more articles and reports from our ever-growing field.
| References | |  |
| 1. | |
| 2. | |
| 3. | Chachar A, Mian A. Intersection of social determinants and child and adolescent mental health services: A case for social psychiatry in Pakistan. World Soc Psychiatry 2022;4:69-77.  [Full text] |
| 4. | Pumariega AJ, Joshi SV. Culture and development in children and youth. Child Adolesc Psychiatr Clin N Am 2010;19:661-80. |
| 5. | Lester BM, Tronick E, Nestler E, Abel T, Kosofsky B, Kuzawa CW, et al. Behavioral epigenetics. Ann N Y Acad Sci 2011;1226:14-33. |
| 6. | Alegria M, Vallas M, Pumariega AJ. Racial and ethnic disparities in pediatric mental health. Child Adolesc Psychiatr Clin N Am 2010;19:759-74. |
| 7. | Rothe EM, Tzuang D, Pumariega AJ. Acculturation, development, and adaptation. Child Adolesc Psychiatr Clin N Am 2010;19:681-96. |
| 8. | Pumariega AJ, Rothe E. Leaving no children or families outside: The challenges of immigration. Am J Orthopsychiatry 2010;80:505-15. |
| 9. | Pumariega AJ. Systems of care. In: Pissacroia M, editor. Textbook of Mental and Behavioral Disorders in Adolescence. Ch. 5. Padova, Italy: PICCIN Publishers; 2017. p. 49-62. |
| 10. | Pumariega AJ, Winters N. Community-based treatment and services. In: Volkmar F, Martin A, editors. Lewis's Child and Adolescent Psychiatry: A Comprehensive Textbook. 5 th ed., Ch. 6.3.4. Philadelphia: Lippincott, Williams, & Wilkins; 2017. |
| 11. | Pumariega A, Gogineni R, Benton T. Poverty, homelessness, hunger in children and adolescents: Psychosocial perspectives. World Soc Psychiatry 2022;4:54-62. [Full text] |
| 12. | Mihajlovic A, Segalit L. Mental health disparities of Ukrainian children exposed to war: A narrative review. World Soc Psychiatry 2022;4:63-8. [Full text] |
| 13. | Farajallah I. Continuous traumatic stress in Palestine: The psychological effects of the occupation and chronic warfare on Palestinian children. World Soc Psychiatry 2022;4:112-20. [Full text] |
| 14. | Cagande C, Marwaha R, Rahmani M, Gogineni R. Children orphaned due to COVID-19 pandemic: Learning from the past and preparing for their future. World Soc Psychiatry 2022;4:101-5. [Full text] |
| 15. | Yilmaz H, Prajapati P, Dalkilic D, Unlu A, Rahmani M, Pumariega A. Impact of rural-urban immigration on substance use in a sample of Turkish youth. World Soc Psychiatry 2022;4:132-8. |
| 16. | Botbol M, Lebailly T, Laplace S, Saint André S. A psychodynamic perspective on psycho traumas in children and their psychosocial consequences. World Soc Psychiatry 2022;4:106-11. [Full text] |
| 17. | Rahmani M, Pumariega A, Prajapati P, Dalkilic A, Yilmaz H, Unlu A. Anomie, loneliness, and psychopathology: Results from the study of youth in Istanbul. World Soc Psychiatry 2022;4:121-31. [Full text] |
| 18. | Pacheco P, Andrews S, Chaskel R. Strabismus and quality of life: The impact of surgical intervention in children and adolescents in Colombia. World Soc Psychiatry 2022;4:159-63. [Full text] |
| 19. | Rothe E. Inside the mind of the adolescent school shooter: Contributing factors and prevention. World Soc Psychiatry 2022;4:85-93. [Full text] |
| 20. | Pumariega A, Millsaps U, Richardson G. Systematic youth suicide screening in a general hospital setting: Process and initial results. World Soc Psychiatry 2022;4:164-73. [Full text] |
| 21. | Di Nicola V. Beyond shared care in child & adolescent psychiatry: Collaborative care and community consultations. World Soc Psychiatry 2022;4:78-84. |
| 22. | Janssens A, Dongen T, Glazemakers I, Uvin K, Pumariega A, Deboutte D. Level of care determination: The Child and Adolescent Service Intensity Instrument (Dutch version). World Soc Psychiatry 2022;4:139-51. [Full text] |
| 23. | Ono Y, Pumariega A, Yamamoto A, Yoshida K, Nakayama H, Nakanishi D, et al. Child and Adolescent Service Intensity Instrument (CASII) development in Japan: Initial psychometrics and use. World Soc Psychiatry 2022;4:152-8. [Full text] |
| 24. | Guzman J, McPherson P, Allen S, Alphosus D, Gold D. The physician's role in confronting humanitarian challenges: A guide for action. World Soc Psychiatry 2022;4:94-100. [Full text] |
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