A nationally renowned researcher in pediatric behavioral and mental health, John N. Constantino, MD, joined Children’s as Chief, Behavioral and Mental Health in August 2022. Dr. Constantino is tasked with tackling an enormous challenge: developing a comprehensive program to help stem a serious youth mental health crisis in Georgia and throughout the U.S. Research is at the forefront of his efforts.

“Mental health is a great unmet need in children,” says Dr. Constantino, who also holds a joint appointment as faculty member in the Emory School of Medicine Department of Psychiatry and Behavioral Sciences. “It’s been a serious problem for years, but the confluence of the effects of social media and the pandemic is a one-two punch that has made matters worse. America’s health system doesn’t provide adequate, evidence-based, outpatient recovery pathways for many children, and we’re seeing a lot of kids in crisis.”

Children’s is committed to helping Georgia become a national leader in behavioral and mental health through an endowment with a current balance greater than $550 million, one of the largest investments in child mental health by a healthcare system in U.S. history. Established in 2019, the initiative is focused on expansive, integrated, clinical and research programs. Most recently, Children’s announced the donation of 10 acres of land by the Zalik Foundation that will become Children’s Healthcare of Atlanta Zalik Behavioral and Mental Health Center. Scheduled to open in 2023, this campus will be entirely dedicated to the efforts being led by Dr. Costantino with a focus on evidence-based intervention.

Research will play an integral role in the endeavor by systematically monitoring the impact of the delivery of timely, evidence-based mental health care to populations of children and families who would otherwise have only marginal access to such service under conditions of care as usual. Three initial areas of focus will be:

• Very young children and families. This involves integrating a suite of interventions for fragile, young families whose children are at very high risk of mental health impairment. By stabilizing and supporting these families, from the early days of a child’s life, practitioners may ward off mental health risks. “With a new baby, you have a brand new brain not yet affected by life’s crises,” says Dr. Constantino. He plans to establish a method to deliver evidence-based care to a cohort of infants and young children – within metro Atlanta and some rural environs – to assess and address these unmet risks from an early age.
• Adolescents at risk of suicide. The U.S. has been lacking in systematically delivering mental health recovery pathways to young people at an intermediate risk for suicide, which is the second leading cause of death in adolescents. Explains Dr. Constantino, “Currently, in Georgia, if a child is discovered to be at imminent risk for suicide they are hospitalized. But those at intermediate risk, or who have left the hospital, often have no defined, evidence-based recovery pathway.” His plan is to develop an integrated pathway for these children, applying existing and upcoming research to the initiative so that fewer at-risk children will be making return visits to the emergency department.
• Leveraging adjacent research programs. In an extension of the efforts of leading experts from Emory and Children’s—pioneers in early childhood intervention, behavioral support for children with developmental disorders, school-based mental health, and the treatment of adolescent mood, anxiety, and substance use disorders—Dr. Constantino plans to incorporate cutting edge methods and technologies into the delivery of high-quality mental health care to the current generation of children in Georgia.

Research is key, Dr. Constantino says. “Basically, we need another kind of science to apply to the field. The way science has worked in pediatric mental health services has typically been through the analysis of singular types of intervention and their short-term impact. And what we don’t know is the joint influence of multiple interventions and their long-term impact.”