The Covid-19 pandemic and the resulting social and environmental changes exacerbated an already existing crisis of children’s mental health. Reports by researchers, clinicians, families, and youth have documented increasing rates of depression, anxiety, and suicidal behaviors among youth. The national declaration the children’s mental health emergency by AACAP, AAP and CHA called attention to worsening access to care that had existed prior to the pandemic. The pandemic also highlighted disparities in health care access and treatment, especially for minoritized populations and girls, and the impact of social determinants of health as major drivers for health outcomes, including mental health. Unprecedented national focus on children’s mental health, highlighted by the surgeon general’s report, provides opportunities for psychiatrists along with other mental health professionals to create mental health systems that will better serve our nation’s youth and families.