Dear Colleagues,

As pediatric providers dedicated to providing high-quality care for children and adolescents, many of us have experienced an unprecedented surge in mental health needs among our patients. The COVID-19 pandemic has exacted an enormous toll on children’s mental health: exacerbating social isolation, depression, anxiety, and trauma, and further straining our already fragile mental health care system.

The American Academy of Pediatrics and American Academy of Child and Adolescent Psychiatry jointly declared the soaring rates of child mental health conditions a national emergency and have identified pediatric providers as critical gateways for expanded access to mental health screening and care.

In my pediatric practice, many of the children and adolescents I care for are also contending with significant social needs including poverty, food and housing insecurity, exposure to violence, and racism. These experiences are often traumatic and contribute to high rates of mental and physical health disorders as well as to disparities in needed care.

My team and I have implemented universal screening for both mental health conditions and the social determinants of mental and physical health that place children at high risk for mental illness. We see universal screening for these risks as a critical step to early identification and ensuring access to and engagement in care and support.

Younger children have not been spared from this crisis—more than 20% of 5-12-year-olds report worsened mental health since the start of the pandemic. As a pediatrician, a large part of the role I play in mental health prevention and care is giving our youngest patients—and their caregivers—the language and tools needed to express their feelings and emotions.

Finding the right mental health educational tools to share with parents and younger patients can be challenging. That is why I was excited to learn of the Depression and Bipolar Support Alliance (DBSA) Mood Crew®, a program of ten emotion-based characters created to support children’s mental health and help parents, caregivers, educators, and clinicians start conversations about emotions with children ages 4 to 10. Each character comes with a biography and various activities to encourage better understanding of emotions. As the child and adult explore the interactive Mood Crew activities together, young ones will begin to build a basic emotional vocabulary that can support lifelong mental health.

We can turn the tide on the children’s mental health crisis by supplying our families with building blocks for resilience. Learning how to communicate “big” feelings is often the first step in prevention, and for children with more serious needs, to healing.


Nicole Brown, MD, MPH, MHS
Chief Health Officer, Pediatrician
Strong Children Wellness Medical Group, PLLC

Nicole Brown, MD, MPH, MHS is a general pediatrician and health services researcher and is the founder and Chief Health Officer of Strong Children Wellness. Her research and professional interests center on enhancing care and service coordination for children who have experienced trauma and those with chronic mental health needs in the pediatric primary care setting.

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