An Interview with IACAPAP Medal 2024 Winners

1. Reflecting on Your Journey: Can you share some of the key highlights of your career in child and adolescent mental health, including any defining moments or experiences that shaped your path?

A key highlight was my experience in the Boston Change Process Study Group, where I studied infant research and learned about the critical importance of the first 1000 days of life and how infant-caregiver relationship forms the foundation of the future success of the older child and adult that the infant will become.  I became proficient in analyzing videotape and began to bring this new knowledge and skill to orphanages in El Salvador and then student nurses in North India.

Another highlight was introducing the Newborn Behavioral Observation, a tool designed to support the infant-caregiver relationship, to my colleagues in Pakistan. During the pandemic my Pakistani colleague onsite administered the NBO, with me coaching her remotely, to mothers and infants from the villages. The trial was a great success and formed the basis for teaching an adapted infant parent mental health curriculum (“Building Baby Brains”) to Lady Health Workers in rural Pakistan. I continue to meet with these remarkable women in monthly mentorship groups.

The last highlight I will mention is my return to El Salvador to collaborate with a local institution to create a residential program for young pregnant teens in which we care for them and their infants during the pregnancy, delivery, and the neonatal period. What I am continuing to learn about resiliency from these young girls and their infants is challenging my psychoanalytic and developmental science theories and challenging me to open my mind to alternative theories that enrich my work as a clinician and a teacher.

2. Advice for Early Career Professionals: What advice would you give to early-career mental health professionals who are looking to make meaningful contributions to the field?

Psychiatry is more than a profession—it is a calling. For early-career professionals, my advice is to keep seeking meaning in the work you do. Serving “the last, the least, and the lost” offers deep purpose and resilience amid the challenges. 

Instead of thinking purely in terms of jobs or careers, ask yourself: What is my calling? Finding that purpose will help you sustain your passion and wellbeing in the long run. 

Three things have kept me grounded: 

• Work-life harmony, not balance, because both domains enrich each other. 
• Collaborative teamwork, where interdependence is a strength. 
• And a commitment to lifelong growth, through reflection, learning, and curiosity. 

Engaging in research—especially that which advances care and prevention—has kept me searching for answers in a field still full of unknowns. 

3. The Role of Mentorship: How has mentorship played a role in your professional growth, and what qualities do you think make a great mentor?

I’ve been fortunate to encounter mentors serendipitously throughout my career. My first supervisor was formative—he taught me not only how to think clinically but also how to reflect deeply. Daily discussions with him shaped my early professional identity. 

Beyond psychiatry, I learned from colleagues in medicine, ethics, and public health. One mentor—an editor of our national medical association newsletter—encouraged me to write. Through op-eds and essays, I discovered my voice, and more importantly, my calling. 

Great mentors do more than teach. They listen, guide, challenge, and empower. They help you become more of who you already are. 

4. Impact of IACAPAP: How has IACAPAP influenced your career?

IACAPAP has broadened my professional lens and allowed me to adopt a truly global perspective on child and adolescent mental health. It connected me to peers and practices from around the world and helped me appreciate cultural and contextual diversity in mental healthcare.

Over the years, it has also offered opportunities to synthesize ideas and adapt innovations to suit local needs. And quite literally, it gave me the chance to travel across the globe to meet, listen to, and learn from the very populations we aim to serve.

5. Future Directions: Looking ahead, what do you believe are the most pressing challenges or exciting opportunities in child and adolescent mental health globally?

Looking ahead, I believe four major challenges lie before us, aligned with WHO’s identified gaps: governance, services, information, and resources.

• Collaboration is essential—not just in principle, but in action. We must share resources and avoid reinventing the wheel.
• Co-creation with youth and caregivers is vital. Interventions will only be effective if they are meaningful and acceptable to those we serve.
• Competency-based training must take precedence over qualification-driven models, especially in low-resource settings. We need to optimise the use of allied health professionals and community workers in supporting youth mental health.
• Finally, cost remains a pressing issue. Embracing scalable solutions, including digital technologies and AI, will be crucial to expanding access affordably and equitably.

The future of child and adolescent mental health will demand innovation—but always anchored in empathy, equity, and partnership.

1. Reflecting on Your Journey: Can you share some of the key highlights of your career in child and adolescent mental health, including any defining moments or experiences that shaped your path?

My journey in global child and adolescent mental health began with a deep sense of responsibility towards the most vulnerable—those with neurodevelopmental differences who often lacked access to even the most basic care. A defining moment was my work during the Marmara Earthquake emergency in Turkey, where I witnessed firsthand the intersection of disaster, trauma, and neglect of mental health needs – in fact, the latter predated the disaster. This experience catalysed my lifelong commitment to integrating developmental psychiatry into public health and policy. At Boston Children's Hospital, I founded the first NIH-sponsored program in Mental Health and Developmental Disabilities (MHDD) which has been an important milestone. It provided an advanced collaborative model that combined interdisciplinary training, research, and clinical service. Directing the Leadership Education in Neurodevelopmental and Related Disabilities (LEND) psychiatry core for over two decades has been equally meaningful, enabling me to mentor a generation of clinicians and researchers that not only included national trainees, but visiting international trainees and medical and public health students. Equally pivotal were my contributions to the classification of Intellectual Developmental Disorders for the WHO ICD-11 and the APA DSM-5, ensuring these reflect both intellectual functioning and adaptive behavior—thus aligning classification with real-world care and equity.

2. Advice for Early Career Professionals: What advice would you give to early-career mental health professionals who are looking to make meaningful contributions to the field?

The field of child and adolescent mental health offers unparalleled opportunities to make a difference. To early-career professionals, I would say: align your work with your deepest values, stay humble in the face of complexity, and always seek to understand the broader context—cultural, historical, and systemic. Be fearless in bridging disciplines, especially when addressing mental health in under-resourced or humanitarian settings. Invest in building long-term collaborations and never underestimate the importance of mentorship and teaching. Let your scholarship be a vehicle not just for discovery but for advocacy, capacity building, and systems change.

3. The Role of Mentorship: How has mentorship played a role in your professional growth, and what qualities do you think make a great mentor?

Mentorship has been a cornerstone of my growth and a responsibility I have always embraced with great care. Growing up on the Mediterranean island of Cyprus during a time of intense communal strife, I learned early on that resilience is forged by the guidance of our teachers. My formative years at the bicommunal English School in Nicosia taught me the value of dialogue and shared purpose across different perspectives. That foundation carried me to University College in London, and eventually across the Atlantic to begin my residency at Massachusetts General Hospital—an opportunity made possible by a great teacher, Jonathan Borus, who, in my view, remains the most remarkable residency training director. Under his leadership, our program flourished “beneath the Ether Dome,” cultivating a truly exceptional learning environment.

At MGH, Gerald Klerman’s mentorship inspired me to pursue doctoral training in psychiatric epidemiology at the Harvard School of Public Health (HSPH), a decision that would fundamentally shape my academic path. During that time, I was privileged to be mentored by Chester (Chet) Pierce, whose weekly meetings and enduring wisdom left an indelible mark. Chet generously continued our annual “follow-up” meetings in Harvard Square for years and once gifted me with a visit to the home of Henry Murray—of TAT fame. Many of our conversations centered on global health, then a rare pursuit, and were foundational to my later work with UNICEF following the Marmara earthquakes in Turkey.

At HSPH years, I grew close to Leon Eisenberg and Carola Eisenberg—luminaries whose brilliance and profound humanity I deeply cherished. Through their example, I began to find my voice as an educator. I am equally grateful to Tony Earls, whose guidance helped me secure my first NIMH K-award, and to Myron Belfer, IACAPAP’s honorary president, whose mentorship helped launch my academic career in child and adolescent psychiatry. I had the privilege of following in the footsteps of Ludwik Szymanski at Boston Children’s. Ludwik, together with Jim Harris, shaped my understanding of developmental psychopathology, weaving together developmental, psychobiological, and social perspectives.

In turn, I have sought to pay this legacy forward by mentoring over 100 postdoctoral fellows and junior faculty, many from low- and middle-income countries, through NIH/NIMH and Fogarty-supported training programs, and through the LEND network. To me, a great mentor listens deeply, creates meaningful opportunities, respects the mentee’s unique trajectory, and fosters ethical and interdisciplinary thinking. At its best, mentorship is reciprocal—it transforms the mentor as much as the mentee. Above all, authentic mentorship is built not only on experience but on dedication, integrity, and a commitment to the growth of others.

4. Impact of IACAPAP: How has IACAPAP influenced your career?

IACAPAP has served as a guiding compass throughout my career. It offers a unique global platform to build bridges across disciplines, cultures, and generations. The organization’s enduring emphasis on equity, capacity-building, and the rights of children has deeply resonated with my own values. Through its expansive international network, IACAPAP has amplified the reach and impact of collaborative research and training initiatives—particularly in LMICs—by fostering meaningful dialogue, mentorship, and the dissemination of innovative approaches to care. 

My connection with Donald J. Cohen dates to a week-long NIMH networking meeting for K-awardees in Pittsburgh, where I had the privilege of being assigned to him as my preceptor. Donald was a visionary who championed global child mental health and, like Myron Belfer, played a pivotal role in broadening IACAPAP’s focus to include the needs of children in under-resourced settings. To my mind, their shared commitment to equity and capacity-building exemplifies the very best of IACAPAP’s mission. 

I came to further appreciate Donald’s enduring legacy during my visits to Israel with Ludwik Szymanski, where I met Nathaniel Laor—a psychiatrist, philosopher, and a leading voice in the study of collective trauma. His work became a profound source of inspiration during my involvement with UNICEF following the Marmara earthquakes. In its early phase, I was honored to join the Donald J. Cohen Fellowship Program as a mentor when invited by Andrés Martin and Joaquín Fuentes. One of the fellows, Muideen O. Bakare, became a treasured mentee, collaborator, and dear friend. 

5. Future Directions: Looking ahead, what do you believe are the most pressing challenges or exciting opportunities in child and adolescent mental health globally?

Globally, we face dual challenges in child and adolescent mental health: expanding the reach of services and ensuring quality, equity, and cultural relevance. The ongoing crises—climate change, conflict, displacement—demand scalable, community-embedded mental health strategies. Yet equally, we must grapple with the digital and ethical frontiers of care, including AI, social media, and genomics. I see exciting opportunities in integrating developmental science with global health policy, emphasizing preventive interventions, and reinforcing the inclusion of individuals with intellectual and developmental disabilities in all aspects of care and research. Above all, we must train the next generation of child mental health professionals to be adaptive, collaborative, and ethically grounded.