RIVERSIDE, Calif. -- A special issue of the journal Child and Adolescent Psychiatric Clinics of North America seeks to shift how clinicians, educators, and policymakers think about girls' mental health by focusing on the systems that support — or fail to support — them.
The issue, titled "Transforming Systems of Care for Girls," grew out of 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 professor and chair of psychiatry and neuroscience in the UC Riverside School of Medicine , explained that the journal collaboration was a natural extension of the institute's focus on how schools, healthcare systems, and community supports interact to influence 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 serves as a co-editor of the special issue with two colleagues. "This includes understanding how gender and intersecting identities shape experiences in schools, community settings, and clinical care."
The special issue features 13 review articles, each summarizing the current literature on a topic related to girls' mental health and offering clinical recommendations. Contributors include both senior and junior researchers. One of the central themes is intersectionality: exploring how factors such as race, disability, immigration status, and socioeconomic background intersect with gender to affect access to care and mental health outcomes.
"We saw a need to address not just girls in general, but the diversity of girls' experiences," said Dr. Michelle Porche , a contributor to the issue and professor in-residence of internal medicine in the UCR School of Medicine. "Systems often overlook how multiple identities influence risk, resilience, and access to services."
The special issue also tackles timely topics such as the impact of social media on body image, depression, and suicidality. One featured 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 important. She explained that rates of anxiety, eating disorders, and self-harm among girls reportedly rose during the COVID-19 pandemic, and concerns about their mental health continue to grow.
"At the same time, discussions about gender — an essential lens for understanding girls' experiences — face increasing political resistance in some circles," she said. "Clinicians and researchers can't ignore the realities girls are living. Even when discussion of gender becomes controversial, the lived experiences of children don't disappear."
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 is officially dated January 2026 and is available through institutional subscriptions, academic libraries, and the journal website.
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In the preface , Fortuna and her co-editors describe a growing mental health crisis among adolescent girls in the United States, characterized by rising rates of anxiety, depression, suicidality, and trauma. They emphasize that girls' mental health is shaped not only by individual experiences but also by the systems that surround them — including schools, families, health care, and social services.
The editors argue the special issue calls for a shift away from fragmented approaches toward holistic, collaborative, trauma-informed, and justice-oriented systems of care. They note that the crisis is preventable through informed policy and practice and urge 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 bring into schools, courts, clinics, and community programs. They argue for approaches that move beyond being merely trauma-informed to becoming trauma-responsive — intentionally designed to prevent re-traumatization and actively promote healing.
In the closing article, Porche joins another contributor in "The Intersection of Educational and Cognitive Diversity Factors for Girls Impacted by the Carceral System." This article calls for greater recognition of and support for neurodivergent girls, whose educational and cognitive needs are too often poorly addressed in schools and overlooked within carceral systems.
The University of California, Riverside is a doctoral research university, a living laboratory for groundbreaking exploration of issues critical to Inland Southern California, the state and communities around the world. Reflecting California's diverse culture, UCR's enrollment is more than 26,000 students. The campus opened a medical school in 2013 and has reached the heart of the Coachella Valley by way of the UCR Palm Desert Center. The campus has an annual impact of more than $2.7 billion on the U.S. economy. To learn more, visit www.ucr.edu .
