Objective: The objective of this topical review is to provide a rationale for the development of standards of care to address the mental health needs of caregivers of youth with chronic and acute conditions. Method: In this topical review, we describe the relationship between pediatric medical conditions and caregiver mental health, the state of available screening and intervention options, standards of care in medicine, existing caregiver mental health standards in pediatric subspecialty populations, and exemplar caregiver mental health programs that were developed in response to standards. Finally, we will describe our rationale for this standard of care, provide a call to action, and describe anticipated challenges in developing and implementing such standards. The content of this topical review was guided by expert knowledge, literature review, and communication with members of the American Psychological Association Division 54 through listserv communication. This review did not involve human subjects research and thus did not require Institutional Review Board approval, informed consent, or assent. Results: Standards of Care to address caregiver mental health in pediatrics is one approach to reduce gaps between caregivers’ needs and access to treatment. Standards that address caregiver mental health exist for a subset of pediatric medical subspecialty populations but are nonexistent across most pediatric populations. Conclusions: Multidisciplinary collaboration, with broad stakeholder input, could result in the writing of Standards of Care to lead to program development that addresses mental health for caregivers of children with a range of chronic and acute conditions. Implications for Impact Statement: This topical review calls attention to the gap between what is known about the mental healthcare needs of caregivers of children with chronic and acute conditions and the implementation of assessments and interventions to address these needs. The development of standards of care is one way to bridge this gap and could lead to the development of universally implemented caregiver mental health supports in pediatric healthcare settings.

Introduction: Providing quality healthcare for children includes assessing and responding to needs of their family caregivers. Three salient domains to consider are caregivers’ early adverse childhood experiences (ACEs), their current levels of distress, and their resilience in coping with both prior and current stressors. Objective: Determine acceptability of assessing caregiver ACEs, current distress, and resilience in pediatric subspecialty care settings. Methods: Caregivers of patients in two pediatric specialty care clinics completed questionnaires about their ACEs, recent emotional distress, and resilience. Importantly, caregivers also rated the acceptability of being asked these questions. Participants included 100 caregivers of youth ages 3–17 across Sickle Cell Disease and Pain clinic settings. The majority of participants were mothers (91.0%) who identified as non-Hispanic (86.0%). Caregiver race was primarily African American/Black (53.0%) and White (41.0%). The Area Deprivation Index (ADI) was used to assess socioeconomic disadvantage. Results: High levels of caregiver acceptability or neutrality with assessing ACEs and distress, as well as high ACEs, distress, and resilience. Associations were found between caregiver ratings of acceptability with caregiver resilience and socioeconomic disadvantage. Caregivers reported openness to being asked about their experiences during childhood and recent emotional distress, although ratings of acceptability varied according to other contextual variables, such as level of socioeconomic disadvantage and caregiver resilience. In general, caregivers perceived themselves to be resilient in the face of adversity. Conclusions: Assessing caregiver ACEs and distress in a trauma-informed way may provide opportunities for better understanding the needs of caregivers and families in order to support them more effectively in the pediatric setting.

The primary aim of this study was to examine the way in which parent stress, including adverse childhood experiences (ACEs) and emotional distress, pain, and resilience, relates to child pain and mental health variables when families are establishing pediatric pain management care. Participants included 50 parent/patient dyads who were recruited from an outpatient pediatric pain clinic. The study utilized an observational design, including self-report questionnaires (parents, youth) and chart review. Questionnaires gathered information on parent ACEs, recent emotional distress, pain, and resilience, as well as child pain, anxiety, depression, and global health. The area deprivation index was used to assess family socioeconomic disadvantage, and all data were collected in 2021. Results indicated that higher levels of parent pain severity, disability, and generalized pain were associated with child pain and mental health variables, including higher levels of child generalized pain, anxiety, depression, and worse child global health. Results also indicated that high parent pain disability coupled with higher levels of ACEs increased the risk for child generalized pain. Parent factors may impact child pain and mental health variables for youth with chronic pain. Improved understanding of the way in which these parent variables relate to child variables may provide opportunities for improved assessment and care for youth and their families. (PsycInfo Database Record (c) 2025 APA, all rights reserved).