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COVID-19 propelled e-mental health within the Australian health system. It is important to learn from this to inform mental healthcare during future crises. A lexical analysis was conducted of clinician reflections during COVID-19 as they delivered psychiatry services to children and families in New South Wales ( = 6) and transitioned to e-mental health. E-mental health can extend the reach of, and access to psychiatry services, particularly for individuals disadvantaged by inequity. Yet e-mental health can be problematic. It is partly continge