Children’s aims to make Georgia a national leader in behavioral and mental health care through an endowment of more than $550 million—one of the largest investments in pediatric mental health by a healthcare system in U.S. history. Established in 2019, this initiative is focused on expansive, integrated clinical and research programs, which have been furthered by the recent opening of the Children's Healthcare of Atlanta Zalik Behavioral and Mental Health Center. This campus will be dedicated to efforts being led by John N. Costantino, MD, Chief, Behavioral and Mental Health and Liz and Frank Blake Chair for Children's Behavioral and Mental Health, to confront the increasing number of behavioral and mental health issues affecting children and adolescents using evidence-based interventions.

Behavioral and Mental Health Care at Children's

Initially available via internal referral, we offer telehealth and in-person services, including medication management, psychiatric assessments, brief supportive psychotherapy, referrals to community care, as well as bridge care for patients with acute psychiatric needs awaiting long-term treatment within the community.

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Research plays an integral role in advancing our approach to behavioral and mental health care, allowing us to systematically monitor 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 services.

Three initial areas of focus are:

  • 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 areas—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. 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. He will accomplish this by building upon the efforts of leading experts from Emory University 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.

Research is key to all of these initiatives, according to Dr. Constantino. “Basically, we need another kind of science to apply to the field,” he says. “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. What we don’t know is the joint influence of multiple interventions and their long-term impact.”

Documenting Opportunity for Systematic Identification and Mitigation of Risk for Child Maltreatment

  • Tandon, M., Jonson-Reid, M., Constantino, J.N. J Am Acad Child Adolesc Psychiatry. 2022 Nov;61(11):1313-1316. doi: 10.1016/j.jaac.2022.05.008. Epub 2022 Jun 8. PMID: 35690303

Reducing Abuse and Neglect Recurrence Among Young Foster Children Reunified With Their Families

  • Constantino, J.N., Buchanan, G., Tandon, M., Bader, C., Jonson-Reid, M. Pediatrics. 2023 Sep 1 ;152(3):e2022060118. doi: 10.1542/peds.2022-060118. PMID: 37622236

Bridging the Divide Between Health and Mental Health: New Opportunity for Parity in Childhood

  • Constantino, J.N. J Am Acad Child Adolesc Psychiatry. 2023 May 23:S0890-8567(23)00249-6. doi: 10.1016/j.jaac.2023.03.019. Online ahead of print. PMID: 37230286

Poverty and Developing Brain

  • Luby, J.L., Constantino, J.N., Barch, D.M. Cerebrum. 2022 Mar 1;2022:cer-04-22. eCollection 2022 Mar-Apr. PMID: 35813304; PMCID: PMC9224364.

Prospects for Leveling the Playing Field for Black Children With Autism

  • Constantino, J.N., Abbacchi, A.M., May, B.K., Klaiman, C., Zhang, Y., Lowe, J.K., Marrus, N., Klin, A., Geschwind, D.H. J Am Acad Child Adolesc Psychiatry. 2023 Sep;62(9):949-952. doi: 10.1016/j.jaac.2023.05.005. Epub 2023 May 15. PMID: 37196781

GABBR1 monoallelic de novo variants linked to neurodevelopmental delay and epilepsy.

  • Cediel, M.L., Stawarski, M., Blanc, X., Nosková, L., Magner, M., Platzer, K., Gburek-Augustat, J., Baldridge, D., Constantino, J.N., Ranza, E., Bettler, B., Antonarakis, S.E. Am J Hum Genet. 2022 Oct 6;109(10):1885-1893. doi: 10.1016/j.ajhg.2022.08.010. Epub 2022 Sep 13. PMID: 36103875; PMCID: PMC9606381.

Can the "female protective effect" liability threshold model explain sex differences in autism spectrum disorder?

  • Dougherty, J.D., Marrus, N., Maloney, S.E., Yip, B., Sandin, S., Turner, T.N., Selmanovic, D., Kroll, K.L., Gutmann, D.H., Constantino, J.N., Weiss, L.A. Neuron. 2022 Oct 19;110(20):3243-3262. doi: 10.1016/j.neuron.2022.06.020. Epub 2022 Jul 21. PMID: 35868305; PMCID: PMC9588569.

Clinical variants paired with phenotype: A rich resource for brain gene curation

  • Chopra M., Savatt, J.M., Bingaman, T.I., Good, M.E., Morgan, A., Cooney, C., Rossel, A.M., VanHoute, B., Cordova, I., Mahida, S., Lanzotti, V., Baldridge, D., Gurnett, C.A., Piven, J., Hazlett, H., Pomeroy, S.L., Sahin, M., Payne, P.R., Rooney Riggs, E., Constantino, J.N.; Brain Gene Registry Consortium. Genet Med. 2023 Dec 4 ;26(3):101035.doi:10.1016/j.gim.2023.101035. Online ahead of print. PMID: 38059438

Development and Replication of Objective Measurements of Social Visual Engagement to Aid in Early Diagnosis and Assessment of Autism

  • Jones, W., Klaiman, C., Richardson, S., Lambha, M., Reid, M., Hamner, T., Beacham, C., Lewis, P., Paredes, J., Edwards, L., Marrus, N., Constantino, J.N., Shultz, S., Klin, A. JAMA Netw Open. 2023 Sep 5;6(9):e2330145. doi: 10.1001/jamanetworkopen.2023.30145. PMID: 37669054; PMCID: PMC10481232.

Behavioral and Mental Health Provider Education

Created to improve the quality of care provided to patients in our community by equipping physicians with educational tools and resources, this initiative aims to inform healthcare providers on behavioral and mental health issues within the pediatric population.

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