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The nation's child welfare system serves the most vulnerable youth and families and so has been impacted dramatically by the coronavirus disease 2019 pandemic with decreases of abuse reporting, delayed toward permanency, and increased disproportionality. Youth in foster care have increased likelihood of boarding in hospital emergency rooms or nontraditional placements. These issues are magnified in exceptional vulnerable populations such as American Indian and Alaska Native children. The child welfare response to the national mental health crisis offers opportunities to redress chronic gaps and vulnerabilities within the systems of care serving these youth., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Effective partnerships can profoundly impact outcomes for youth with behavioral health concerns. Partnerships occur at multiple levels - at the individual, organizational, state, and national levels. The Systems of Care (SOC) framework helps to conceptualize and articulate the skills necessary for forming partnerships in youth's mental health. This article explores values in the SOC framework and makes the case that the framework can help develop a "road map" to develop the skills needed to achieve successful partnerships. Impediments to effective partnerships are also discussed. Several case examples are given to illustrate the principles and impediments to partnership formation., Competing Interests: Disclosure Dr P. Sharma is a recipient of the Robert A. Winn Diversity in Clinical Trials Career Development Award, funded by the Bristol-Myers Squibb Foundation, United States. He also received funding from the Noaber Foundation, Netherlands, the Mayo Clinic, United States, and the Mayo Clinic Health System. Dr W.D. Lohr is a recipient of a State-University Contract with Kentucky Department for Medicaid funding his position as Medical Director for the Department for Community Services. He also receives research funding from the Health Resources & Services Administration, United States for a Pediatric Mental Health Access Grant. Dr R. Gerson receives royalties from American Psychiatric Association Publishing., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: We aimed to assess the degree to which the American Academy of Pediatrics' (AAP) clinical guidelines were followed when treating attention deficit/hyperactivity disorder (ADHD) in preschoolers., Method: Using Medicaid claims for children 4 to 5 years of age receiving their first dose of stimulants/alpha-2 agonists in 2017 ( n  = 836), we determined if BH was received prior to initiation of medication. We examined predictors after controlling for confounders., Results: More than half the sample did not receive first-line BH, which did not differ by demographics. Those receiving BH prior to medication had a higher rate of receiving an ADHD diagnosis. Only three diagnoses were significant in multivariate (OR 13.8, 95% CI [1.7-115.1]) analyses., Conclusion: More than half the sample did not, conservatively, meet the AAP clinical recommendations. Further research is needed to identify targets for intervention. Limitations are noted.