Date of Award

January 2024

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)



First Advisor

Andres Martin


Children’s mental health care has been on the decline since the start of the century. The COVID-19 pandemic further unearthed this significant worsening of mental health in children with heightened levels of anxiety, depression, loneliness, anger, and fatigue leading to an increase in the number of emergency room visits and inpatient hospitalizations. Art and narrative-based interventions are known to improve patient outcomes and are a crucial component of pediatric inpatient psychiatric care. We discuss the process of adoption of a novel therapeutic comic book that was developed for children admitted to the hospital in a psychiatric inpatient unit at Yale-New Haven Hospital. A Hero’s Journey, a 38-page zine, is a short booklet that was created to demystify the experience of hospitalization, provide scaffolding for skill-building, and promote interaction and socialization. The zine was administered to patients and subsequently, 19 interviews were done with healthcare providers. Using qualitative research methods, a thematic analysis was performed. Three main domains were identified. The main domains of themes were: 1) Implementing or rolling-out of the zine: what worked and what did not work during the process of rollout; 2) Optimizing: the zine was appropriate in length and content for the patient population at hand; 3) Anticipating: the zine has potential areas for growth and development. The zine is a wonderful resource. Yet its implementation faced many challenges including staffing shortages and time constraints. Some ways to overcome these are having a champion for the zine, educating each user on the content, using individual pages of the zine instead of the whole booklet, and exploring avenues for personalization.


This is an Open Access Thesis.

Open Access

This Article is Open Access