LAUSR

A national state of emergency in children’s mental health was declared by the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children’s Hospital Association on October 19, 2021 [1]. The COVID19 pandemic has disrupted the education of nearly all 55 million kindergarten through 12th grade students in the United States [2, 3]. The recent US Surgeon General’s Advisory on protecting youth mental health [4] underscores rising child mental health needs placing an unprecedented strain on the child mental health care system [5–7]. Together, these forces have been an impetus for child and adolescent psychiatrists and allied professionals to think critically about how to better leverage clinical informatics to meet the mental health needs of children [8] and learn collectively about the growing role of technology-driven and technology-informed modes of practice in supporting quality of child mental health care [9]. There have been two parallel trends over the last decade, both of which have been accentuated by the pandemic. The first is emotionally palpable to clinicians working with children and families: the rates of childhood mental health concerns and suicide have risen steadily throughout the decade [10]. By 2018, suicide reached the second leading cause of death among young people aged 10 to 34 years [11], and during 2020 there were dramatic increases in emergency department visits for suicide-related behavior among youth [12, 13]. The second trend is an extremely rapid growth in health data, including patient access to data, and health care decision-making based on health information technology. However, the combination of rising child mental health care needs and the rapid advancement of digital health technologies is also coupled with a significant divide between child psychiatry and training in clinical informatics [14]. Notably, few child psychiatrists have had formal training or developed skillsets to adapt, develop, or critically evaluate the use of electronic health records (EHRs) at point of care, or to interpret the growing body of scientific literature leveraging EHRs to generate evidence for child psychiatry research [15]. This is a critical time for child mental health care. There is a growing recognition of the role of health data in changing clinical practice. There is also a crucial need to narrow the research to practice gap and to connect the traditionally siloed fields of child psychiatry and clinical informatics. In this context, we aim to discuss some of the potential applications of informatics to child mental health and to show how these two fields may be bridged in practice and training. We argue that better connecting these two fields could offer critical pathways for attending to the current crisis in child mental health. At the population level, improving the methods and infrastructure through which child mental health data are routinely collected and subsequently analyzed may help improve public health surveillance, identify inequities and gaps in access to care, and generate new knowledge in the discovery and management of child mental health conditions. At the individual child level, adapting the EHR as a tool for health delivery provides an important avenue to support measurement-based care, improve communication between providers, patients, and families, and mitigate clinician burnout and fatigue. However, the promise of bridging these fields must be tempered with an understanding of the feasibility within the context of workforce * Juliet Edgcomb [email protected]