Mental health disorders (MHDs) are highly heritable and typically start early in life. For 70% of people with a mental illness, symptoms appear before the age of 18 [1]. Recent research has aimed to identify genetic risk and protective factors to improve risk stratification and targeted interventions. However, several barriers still hinder the promise of precision medicine in child and youth mental health. These include:

• small sample sizes,
• limited standardization of phenotyping,
• limited linkage to “real world” data (e.g. electronic health record, administrative health, patient reported),
• lack of representation from people of non-European ancestry potentially exacerbates existing health care inequities.

To address these barriers, the Pan-GEM team, composed of investigators from various fields including psychiatric genetics, pharmacogenetics, data science and health policy, has proposed a large scale Pan-Canadian initiative to connect Genomic, Environmental and Mental Health Data (Pan-GEM) to identify risk factors for MHDs. Short-read whole-genome sequencing will be conducted on 5,250 children and youth, and long-read whole-genome sequencing will be performed on an additional 1,200 children and youth, with an oversampling of individuals of non-European ancestry.

Pan-GEM aims to:

• Build a collaborative, pan-Canadian network of child and youth mental health researchers, leveraging existing networks and resources,
• Develop, validate and share standardized algorithms, workflows, and analysis plans for combining data,
• Co-develop culturally sensitive recruitment/retention, consenting and knowledge translation approaches,
• Sequence samples and combine phenotype data collected through Pan-GEM, conducting analyses of interactions between social determinants of health and genetic variation, and
• Develop practice guidelines and policy recommendations that address the ethical, environmental, economic, legal, and social aspects of genomics through knowledge translation.

Leveraging and amplifying national investments and expertise in mental health genetic research, Pan-GEM will be the largest Canadian collaboration to identify genetic and environmental risk factors for children and youth with MHDs. By addressing current barriers in the field through this unified approach and ensuring diverse representation amongst participants, this work will facilitate advances in precision medicine that will benefit all young Canadians.

[1] Children and Youth. Mental Health Commission of Canada. https://mentalhealthcommission.ca/what-we-do/children-and-youth/