RIVERSIDE, Calif. — A groundbreaking special issue of the journal Child and Adolescent Psychiatric Clinics of North America is calling for a transformative shift in how clinicians, educators, and policymakers approach girls’ mental health. The issue, titled “Transforming Systems of Care for Girls,” highlights the systemic support—or lack thereof—affecting girls’ mental health across various domains.
The initiative stems from an annual institute hosted by the American Academy of Child and Adolescent Psychiatry (AACAP). Dr. Lisa Fortuna, co-chair of AACAP’s Systems of Care Committee and a professor at the UC Riverside School of Medicine, emphasized that this journal issue is a natural progression of the institute’s focus on the interplay between educational, healthcare, and community systems and their influence on girls’ mental health outcomes.
“Rather than looking at just individual diagnoses and treatments, we wanted to broaden the conversation to consider how systems respond to girls’ needs,” said Fortuna, who co-edited the issue. “This includes understanding how gender and intersecting identities shape experiences in schools, community settings, and clinical care.”
Intersectionality and Mental Health
The special issue comprises 13 review articles, each summarizing current literature on topics related to girls’ mental health and offering clinical recommendations. Contributors range from senior researchers to emerging scholars. A central theme is intersectionality, examining how race, disability, immigration status, and socioeconomic background intersect with gender to influence access to care and mental health outcomes.
Dr. Michelle Porche, a contributor and professor in-residence at the UCR School of Medicine, highlighted the need to address the diversity of girls’ experiences. “Systems often overlook how multiple identities influence risk, resilience, and access to services,” she noted.
“We saw a need to address not just girls in general, but the diversity of girls’ experiences,” said Dr. Michelle Porche.
Timely Topics and Social Media Impact
The special issue also delves into timely subjects such as the impact of social media on body image, depression, and suicidality. One article explores interventions that empower girls to engage with social media in healthier, more intentional ways.
According to Fortuna, the timing of the publication is crucial. She pointed out that rates of anxiety, eating disorders, and self-harm among girls reportedly rose during the COVID-19 pandemic, amplifying concerns about their mental health.
“At the same time, discussions about gender—an essential lens for understanding girls’ experiences—face increasing political resistance in some circles,” Fortuna stated.
Advocating for Systemic Change
Fortuna and Porche hope the issue will not only inform clinicians but also influence broader systems to better meet girls’ unique needs. “We want this to be eye-opening,” Porche said. “It’s about recognizing where systems fall short and thinking creatively about how to do better.”
The print issue, officially dated January 2026, is available through institutional subscriptions, academic libraries, and the journal’s website.
Holistic and Trauma-Informed Approaches
In the preface, Fortuna and her co-editors describe a growing mental health crisis among adolescent girls in the United States, marked by increasing rates of anxiety, depression, suicidality, and trauma. They stress that girls’ mental health is shaped not only by individual experiences but also by the systems that surround them, including schools, families, healthcare, and social services.
The editors advocate for a shift from fragmented approaches to holistic, collaborative, trauma-informed, and justice-oriented systems of care. They argue that the crisis is preventable through informed policy and practice, urging increased investment in community-based supports that center girls’ voices, needs, and strengths.
Porche and co-authors, including Fortuna, open the issue with “Trauma and Girls: Implementing Trauma-Informed Policies and Practices in Systems of Care,” highlighting the disproportionate burden of trauma that many girls carry into schools, courts, clinics, and community programs. They call for approaches that move beyond being merely trauma-informed to becoming trauma-responsive, designed to prevent re-traumatization and actively promote healing.
In the closing article, Porche collaborates with another contributor on “The Intersection of Educational and Cognitive Diversity Factors for Girls Impacted by the Carceral System.” This piece calls for greater recognition and support for neurodivergent girls, whose educational and cognitive needs are often inadequately addressed in schools and overlooked within carceral systems.
The University of California, Riverside, a doctoral research university, serves as a living laboratory for groundbreaking exploration of issues critical to Inland Southern California and beyond. Reflecting California’s diverse culture, UCR’s enrollment exceeds 26,000 students. The campus, which opened a medical school in 2013, has a significant annual impact of over $2.7 billion on the U.S. economy. For more information, visit www.ucr.edu.
