Editorial: Fostering Tomorrow for the Future

India is a country currently having the highest population and with many young people. It is estimated that by 2030, there will be a working population of 230 million. The total number of children and adolescents currently exceeds 434 million, of which early 50 million children suffer from mental illness at any given point. There is a rising trend for mental illnesses in children and adolescents and a significant gap in their treatment. Robust measures and policies for the promotion of positive mental health and prevention of mental illness are still yet evolving. To ensure that our children and adolescents grow optimally to lead happy, productive lives, we, as child and adolescent psychiatrists, must ensure that we foster them and provide a better future for them.

With this background and thought in mind, the 2nd CME of the IACAM was organized and hosted by the Department of Psychiatry of TNMC & BYL Nair Ch. Hospital in Mumbai. The two-day program covered a mix of workshops, plenary talks, panel discussions, and a quiz. Delegates present both in the CME hall and online highly appreciated the rich and intense deliberations. The appreciation and perceived utility of these academic deliberations spurred us to come out with this Special Issue dedicated to the Proceedings related to the CME; the seeds for which had already been sown and had started germinating in the fortnight prior to leading up to the date of the CME.

It will be pertinent to mention here as a disclaimer that all the presentations at the CME have not found their way into this Issue due to a multiplicity of reasons (the elaboration of which is beyond the scope and relevance of the editorial). Additionally, this Issue has been divided into three Sections viz. Conceptual Aspects, Addressing Specific Disorders/Illnesses, Assessments/Interventions.

Section A (Conceptual Aspects) comprises five contributions and deals with conceptual dilemmas and issues. Pratap Sharan deliberates on the philosophical ideas regarding childhood and the vexing question of consent. Kersi Chavda & Vinyas Nisarga highlight the growing concern about the increasing number of single parents and the impact on the children’s mental health. Building resilience is an important key to effectively navigating troubled times. Due to the advent of, and experience with COVID-19, digital technology has increased exponentially, and Chhitij Srivastava & Prajakta Patkar summarize the evidence of its impact on child development. Avinash Desousa, Sushma Sonavane & Delnaz Palsetia highlight the role of private practitioners in shouldering the burden of mental health of our young ones. Finally, Mansi Somaiya and her team scan the horizon for upcoming biological treatments, medications, digital therapies, and neuromodulation for common disorders and suggest possible measures for prevention and promotion.

Section B (Addressing Specific Disorders/Illnesses) com- prises six narrative reviews and focuses on specific illnesses and their concerns. Mood disorders are common in children, and Naresh Nebhinani discusses the scale, presentation, comorbidity, differential diagnosis, and management approach of depression and bipolar in children and adolescents. Vivek Agarwal & Kopal Rohatgi describe the risk factors and the methods to identify and effectively manage somatic symptoms and emotional disturbances. They further emphasize the need for a biopsychosocial approach, psychoeducation, a positive approach, and behaviour therapy. Suicide has been showing an upward trend, and Anjali Chhabria & Prerna Khar discuss the causes, especially the role of emotional dysregulation in suicide and aggression. The authors further go on to suggest interventions and methods of prevention. The etiopathogenesis of eating disorders, their presentation, and management are elaborated on by Jai Ram & Swati Shelke. Nidhi Chauhan eloquently gives us an overview of “various hidden difficulties inherent in ADHD but which often is missed in clinical practice.” Priti Arun & Smriti Mahajan identify the trials in the diagnosis and management of Intellectual disability. They underscore the importance of preventive measures and screening and suggest a national newborn screening program.

Assessment and interventions are an integral part of our toolkit. Section C (Assessments/Interventions) includes deliberations on these topics. Roopesh BN offers a critical review of psychological tests, especially the validity of current assessment measures for ability, achievement, and psychopathology. He provides insights on steps to overcome the issues. Rao Pradeep & Morandini H review newer psychopharmacological interventions and focus on the promising use of Ketamine, Nitrous Oxide, Cannabidiol, and cannabis derivates and pharmacogenomics, and demonstrate that these offer immense possibilities for the future. Self-injurious behaviour is a common symptom in neurodevelopmental disorders. However, it is difficult to treat and is poorly understood. Neena Sawant & Bhooshan Shukla review the limited data in this area and offer pharmacological and non-pharmacological approaches to best address this issue. Swati Khanolkar elucidates the management of depressed teens using REBT techniques. Using a case-based method, she identifies the steps and approach for such a patient. Last but not least, Basant Pradhan & Madhusmita Sahoo beautifully review the various modalities of psychotherapy and emphasize the need for eclecticism— “to combine the youth psychotherapies with other modes of treatments, such as medications, disorder-specific neuromodulation interventions (such as magnetic and electric brain stimulation protocols) and, Yoga and mindfulness-based cognitive therapy (Y-MBCT) modalities.” They describe Trauma Interventions using mindfulness-based extinction and reconsolidation of trauma memories (TIMBER), a time-limited and targeted cognitive behavioral therapy that eclectically uses many therapeutic elements.

Hence, it can be seen that this special issue offers a kaleidoscope of views, perspectives, and narrative reviews on many important issues that present to child and adolescent psychiatrists in academic and clinic-based settings. The discussed and reviewed topics are practically relevant and related to our day-to-day practice. We hope that the reader will find the contents useful, which will help him/her to gain insights and utilize practical tips that can be readily translated into practice.