• The Patient-Centered Outcomes Research Institute (PCORI) is partnering with the Agency for Healthcare Research and Quality (AHRQ) to develop a systematic evidence review on Mindfulness-Based Interventions for Mental Health in Children and Adolescents. The Academic Consortium for Integrative Medicine and Health (ACIMH) and the American Academy of Pediatrics (AAP) intend to use the systematic evidence review to inform clinical practice guidance related to the topic.
• Pediatric mental health is often a pressing issue for patients, families, and healthcare providers. Emerging evidence indicates that the prevalence of mental health conditions in youth has risen during the COVID-19 pandemic, with one recent estimate reporting that up to 1 in 5 children and adolescents experience clinically significant depression, and about 1 in 4 may experience anxiety.¹
• Recommendations for the treatment of anxiety and depression in youth are often limited to conventional therapies, including medication and two forms of psychotherapy.^2,3 However, integrative therapies, which are complementary or alternative therapies used alongside conventional treatment, are often used among children in the United States, with nearly 12% of parents reporting the use of these therapies.⁴
• A common type of integrative therapy is mindfulness-based interventions, such as mindfulness meditation or guided imagery.^4,5 These interventions seek to improve wellbeing and health through self-regulation and attention to the present moment.^5,6
• A variety of mindfulness-based interventions are available, and patients, families, and healthcare providers need clarity on the range of safe and effective options.
• The lack of a guideline or recent and comprehensive systematic review, paired with accumulating evidence, indicates the need for a new review of the effectiveness of mindfulness-based interventions.

KQ 1.  What are the benefits and harms of mindfulness-based interventions for mental health and well-being in the general child and adolescent populations?

KQ 2. What are the benefits and harms of mindfulness-based interventions for mental health and well-being in children and adolescents diagnosed with anxiety or depression?

KQ 3. What are the benefits and harms of mindfulness-based interventions for mental health and well-being in children and adolescents with a chronic physical health condition who are at risk for symptoms of anxiety and depression?

1. Racine, N., et al., Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19: A Meta-analysis. JAMA Pediatr, 2021. 175(11): p. 1142-1150.
2. Cheung, A.H., et al., Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part II. Treatment and Ongoing Management. Pediatrics, 2018. 141(3).
3. Walter, H.J., et al., Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Anxiety Disorders. J Am Acad Child Adolesc Psychiatry, 2020. 59(10): p. 1107-1124.
4. Black, L.I., et al., Use of complementary health approaches among children aged 4-17 years in the United States: National Health Interview Survey, 2007-2012. Natl Health Stat Report, 2015(78): p. 1-19.
5. Mind-Body Therapies in Children and Youth. Pediatrics, 2016. 138(3).
6. Dunning, D., et al., Do mindfulness-based programmes improve the cognitive skills, behaviour and mental health of children and adolescents? An updated meta-analysis of randomised controlled trials. Evid Based Ment Health, 2022. 25(3): p. 135-42.