Keynote Lectures

Nonsuicidal Self-Injury (NSSI) has been recognized as a prevalent phenomenon that occurs in the context of various mental health disorders and peaks during adolescence. Although emotion regulation has been described as a primary motive for NSSI in research, interpersonal dynamics and social motivations have also been discussed. Recent research has additionally focused on the social contagion of NSSI, a theme that is particularly relevant with regard to social media coverage of the behavior.

Different lines of research have informed our understanding of the underlying mechanisms and effective treatment strategies. With regard to neurobiological mechanisms, alterations in the autonomic nervous system, brain activation patterns, the HPA axis, pain processing, and the endogenous opioid system have been identified. In terms of psychotherapeutic interventions, Dialectical Behavior Therapy for Adolescents (DBT-A) as well as Cognitive Behavioral Therapy (CBT) have been shown to be effective in reducing the frequency of NSSI.

In recent years, online interventions and mobile applications have received increasing attention, and initial studies have shown promising results. This lecture aims to provide a state-of-the-art overview, spanning from neurobiological mechanisms to treatment approaches.

Across the world, an estimated one in seven adolescents experience mental disorders, yet in low- and middle-income countries the treatment gap may reach 76 to 85 percent, meaning most who need help never receive it. The mental health of children and adolescents is shaped by cultural values, social determinants, and profound inequities in access to care. The current training models do not adequately prepare a workforce to address these inequities or the contexts that perpetuate vulnerability. A global child and adolescent mental health curriculum would build upon the foundation of core clinical competencies to prioritize equity, global burden of disease, and the realities of environments in which children grow, learn, and seek help.

This talk presents the need and framework of such training grounded in essential competencies: developmental and cultural formulation; social determinants and epidemiology; resource mapping and systems strengthening; humanitarian crises; ethics and human rights; equitable care; prevention and community-based support; and cross-sector collaboration. The goal is to build cultural humility, advocacy, and innovation in low-resource settings.

A global curriculum addresses three persistent challenges: disparities in workforce capacity, wide variation in what is taught and to whom, and the absence of shared standards defining minimum competencies. By aligning training with real-world burden and contextual realities, it aims to strengthen systems of care and close persistent gaps in access and quality.

Ultimately, this framework reflects a simple commitment: that every child, everywhere, deserves informed, competent, and compassionate mental health care that upholds dignity, equity, and the possibility of flourishing.

Over the last decades, the predominant focus of research into ADHD has been neurobiological. Although this has delivered us many insights, the narrative might have become too one-sided. A risk is that this emphasis on biological factors has created a deterministic, individualized, and decontextualized view on ADHD. This means that we focus our solutions too much on the individual level, and that the broader context of the child’s problems runs the risk of being neglected. The first part of this lecture will focus on the risks of such decontextualization, such as prognostic pessimism, stigma and overreliance on medication in treatment planning. The second part is a plea for more context in our ADHD narrative, by presenting work from the PAINT consortium on context-focused interventions for families of children with ADHD. 

^{Cecil Prins-Aardema, The Netherlands 
& Andrés S. Martin, USA}

Individuals with mental illnesses and those of us who care for them are not that different from one another. But in being with our patients, how many of us share our fallibility, our vulnerability, our imperfection: how many of us share our own living experience being on “their” side of the aisle?  More to the point: how many of us professionals share with one another? Not nearly enough. We have been too caught up in a maladaptive search for perfectionism and infallibility. Sharing such personal information is understandably a bridge too far for many. When it comes to mental health, little of this state of affairs is due to the facile explanation of breaches in privacy. It is simpler than. And more painful. It is because of stigma.

This presentation builds on an earlier keynote delivered at ESCAP in Strasbourg, 2025. This new presentation will expand that earlier content by incorporating the complementary perspectives of adolescents and young adults, highlighting intergenerational and familial impact on the road to recovery during adolescence and young adulthood.

Climate change is increasingly recognized not only as an environmental and economic crisis, but also as a profound public health challenge with specific consequences for mental health. Children and adolescents are uniquely vulnerable, both because of their developmental stage and their limited control over the conditions shaping their lives. Climate-related events such as extreme weather, forced displacement, food insecurity, and community disruption have been shown to heighten risks for anxiety, depression, post-traumatic stress, and school absenteeism. Beyond acute disasters, the chronic awareness of a changing and uncertain future, sometimes described as “eco-anxiety”, can significantly affect young people’s sense of safety, agency, and hope.

Research highlights that the burden of these impacts is unequally distributed. Children from marginalized communities, including those already facing social and economic disadvantage, are disproportionately exposed to climate hazards and often have fewer resources for recovery. At the same time, young people are not only victims but also active agents of adaptation and change. Many are leading climate movements, developing innovative communication strategies, and calling for systemic action.

For child mental health professionals, climate change presents both an urgent challenge and an opportunity. It requires integrating climate-related stressors into clinical care, research, and policy advocacy, while fostering resilience and collective engagement. This presentation will review current evidence on the mental health impacts of climate change in children and adolescents, highlight inequities, and discuss approaches for clinicians, educators, and policymakers to support the next generation in the face of a warming world.

Although there is consensus today that autism and ADHD are heterogeneous and dimensional phenomena that require individual understanding and tailored support across society, much thinking and action is still predominantly based on a medical model according to ICD-11 and DSM-5. Strictly applying a nosological approach to neurodevelopmental conditions and subclinical traits levels is inappropriate in a modern and fast changing word, valuing diversity and complexity, hampers and delays effective actions, generates inadequate treatment expectancies, overburdens mental health services and is a potential driver of increasing diagnoses rates of autism and ADHD. Categorical diagnoses alone convey little information for planning individualised intervention, they are not solution-oriented and lack information about resources and environmental impact. The WHO's International Classification of Functioning (ICF) allows a more holistic assessment of a person's strengths and challenges, activities, and participation, facilitating and hindering environmental factors and personal factors across clinical, educational, social and everyday spaces. This lecture will introduce to the ICF model, its philosophy, advantages, and application in practice. There will be a particular focus on the adaptation of the ICF for efficient use in autism and ADHD, and the research it builds on.

This talk will explore whether child and adolescent psychiatry can be considered a form of colonialism, drawing on historical, cultural, and epistemological perspectives. Classical colonial psychiatry often served to pathologize cultural difference, as described by Frantz Fanon, with psychiatric categories used to normalize colonized populations and justify domination. Contemporary practices raise similar concerns: diagnostic criteria, randomized trials, and treatment guidelines developed in Western contexts are often imposed globally, despite cultural differences in child development, parenting norms, and understandings of mental health. Examples include the pathologization of impulsivity in ADHD, culturally divergent parenting practices, and the risks of exporting child protection frameworks without cultural sensitivity. Postcolonial trauma also continues to affect second-generation migrant children.

The global mental health movement and initiatives like WHO’s mhGAP illustrate both progress and pitfalls: while evidence-based treatments for conditions such as psychosis, PTSD, and panic disorder show cross-cultural validity, imposing standardized “packages” risks reinforcing epistemological dominance. More subtly, psychiatry inherits from Western natural science a universalist epistemology that privileges objectivity, biological reductionism, and statistical norms, marginalizing therapeutic alliance, spirituality, and culturally specific forms of selfhood.

Thus, psychiatric colonialism can be understood as both visible (through global institutions and practices) and invisible (through scientific and epistemological frameworks). At the same time, certain medical and psychiatric interventions are genuinely universal in their effectiveness. Clinicians must therefore navigate a balance between respecting cultural diversity and acknowledging universals, remaining critically aware of potential colonial dynamics while providing care that is both evidence-based and contextually appropriate.