Keynote Lectures

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.