For this CARRA Large Grant, we aim to survey children who take part in the CARRA registry to find out if they experience increased emotional distress. Emotional distress results from exposure to stress and can lead to more significant mental health problems, which is particularly concerning in light of current traumatic events (e.g., COVID-19 pandemic, natural disasters). The goal is to determine if emotional distress is related to disease outcomes in children with rheumatologic conditions (juvenile idiopathic arthritis, juvenile dermatomyositis, or systemic lupus erythematosus). We will design an educational tool to empower children and parents to recognize emotional distress and other mental health problems and to self-advocate for mental health interventions. The tool will be developed and tested with a co-investigative team of key stakeholders including pediatric rheumatologists, mental health providers, patients, and their caregivers. We will then have the tool reviewed by patients and parents for acceptability.