The treatment of childhood onset of mental illness can be perplexing. Mental illness does not always wait until adulthood; the National Institute of Mental Health estimates 12 million children and adolescents have a diagnosable mental disorder. The availability of evidence that guides treatment tends to be sparse and few medications are Food and Drug Administration (FDA) approved for the use in those who suffer yet are younger than eighteen. One notable exception, attention-deficit, hyperactivity disorder (ADHD), has garnered enough evidence for solid treatment options. Drs. Linn, Murray, Smith and Fuentes review clinical considerations in the management of ADHD in a pediatric population.

Children and adolescents often exhibit symptoms of mental illness at different frequencies and severities as compared to adults. As this may suggest, treatment modalities also affect children and adolescents differently than they do adults, and one must use caution when extrapolating evidence found only in the adult population. Studies in children and adolescents are conducted at a vastly slower rate than those of adults, though some of it is promising.

One patient population that has received some attention of late are foster children. In this issue of the Mental Health Clinician, you will find a discussion on psychotropic use in this particular population and how psychiatric pharmacists can play a role in ensuring appropriate use of psychotropic medications in those patients in foster care.

This issue of the MHC will also review some evidence for medication use in children depression, tic disorders, and the use of antipsychotics in various mental disorders. Also included is an article on screening for depression and suicidality in our youth. A discussion regarding an adverse effect of enuresis caused by antipsychotic use is incorporated into this issue. Finally, a compilation of psychotropic medications approved for use in children and adolescents is provided as a toolbox.