BOSTON — The state’s political leaders are weighing how to expand services for youth as medical experts warn of a ‘tsunami’ of mental health issues in the wake of the pandemic.

While children were spared the worst health effects of the COVID-19 outbreak over the past year, their mental health was a much different story.

Lockdowns, school closings and restrictions on social gatherings to prevent the spread of the virus, coupled with a lack of access to in-person services, exacerbated a mental health treatment gap for children, medical experts say. Low-income and minority children were disproportionately affected.

Schools have found themselves on the frontlines of the problem, which has been manifested in a rise of violence. In Lawrence, the high school has reported several fights among students in the past week, which some officials have linked to anxiety and tension among students returning to in-person classes.

“There’s no question that we’re facing a youth mental health crisis,” said Dr. Michael Yogman, a pediatrician at Cambridge Hospital and assistant professor of pediatrics at Harvard Medical School. “The situation in Lawrence is not isolated — it’s happening all across the country.”

Yogman, who chairs a youth mental health task force at the Massachusetts chapter of the American Academy of Pediatrics, said many people underestimated the emotional impact of the transition back from remote to in-class learning.

“They’ve lost their social skills because they’ve been locked down and isolated for the past year and a half,” he said.

Earlier this week, a coalition of health groups including the American Academy of Pediatrics and American Academy of Child and Adolescent Psychiatry issued a dire warning that the youth mental health crisis has become a “national emergency.”

“We are caring for young people with soaring rates of depression, anxiety, trauma, loneliness and suicidality that will have lasting impacts on them, their families, their communities, and all of our futures,” the coalition said in a statement. “We cannot sit idly by.”

The declaration calls on state and federal leaders to fund and improve mental health care for children with more screening, diagnosing and treatment.

On Beacon Hill, policymakers are considering a number of legislative proposals aimed at dealing with the problem.

Gov. Charlie Baker wants to divert a portion of $4.8 billion in federal pandemic relief the state has received to substance abuse treatment and behavioral health services.

Baker said the state has devoted “significant” money and resources to communities like Lawrence to deal with child mental health issues, but said a major challenge for the state is a lack of counselors and other behavioral health workers.

“The biggest challenge we face in mental health services — and pediatric mental health services in particular — is a human capital problem,” he told reporters at a Monday briefing.”We’re going to have to invest to grow that human capital.”

Senate President Karen Spilka, D-Ashland, said this week that the issue is at the top of her agenda, and she expects a “mental health reform bill” to emerge from the Senate before the end of the year.

Earlier this week, the House rolled out a plan to spend $3.65 billion in American Rescue Plan Act funds and surplus revenue that would divert $250 million specifically for behavioral health programs. The money would be focused on initiatives such as student loan reimbursement and training.

Recent studies support claims that mental health issues are growing among children even as the pandemic subsides.

More than 20% of teen hospitalizations between Jan. 1 and March 31 were for psychiatric emergencies, according to the U.S. Centers for Disease Control and Prevention.

In 2020, the percentage of emergency department visits for mental health emergencies rose by 24% for children between the ages of 5 and 11 and 31% for those 12 to 17, compared with 2019, federal data shows.

Nationally, there were 50% more suicide attempt-related hospital visits among girls aged 12 to 17 in early 2021 than in early 2019, the federal agency said.

Meanwhile, a shortage of staffing and beds in mental health units means young people often end up “boarding” in emergency rooms while waiting for services.

As of last Friday, there were at least 172 pediatric patients awaiting beds in psychiatric facilities across Massachusetts, according to state health data.

Massachusetts isn’t the only state wrestling with a backlog of psychiatric patients looking for treatment.

In New Hampshire, state officials plan to spend $15.1 million in federal relief funds to buy a private psychiatric hospital and expand mental health services for youth.

Gov. Chris Sununu, who proposed purchasing the hospital, said the move will help ease a mental health crisis by providing more beds for youth seeking treatment. As of Monday about two dozen individuals were waiting for beds in psychiatric facilities, according to state public health data.

Sununu signed an executive order in May directing the state Department of Health and Human Services to improve access to mental health services and add more beds at state-run psychiatric facilities to reduce the number of patients being held involuntarily in emergency rooms while they await placement.

The order followed a New Hampshire Supreme Court ruling that chided the Sununu administration for boarding psychiatric patients awaiting beds.

Danna Mauch, president and CEO of Massachusetts Association for Mental Health, credits the state for taking a number of steps to help deal with the staffing and bed shortages by increasing reimbursement rates for providers, loan forgiveness and scholarship programs to expand the behavioral health workforce.

“But the one thing that you can instantly do is create licensed personnel,” she said. “Even with the incentives, it still takes a number of years to train and license a certified professional in the field.”

Mauch said resolving the issues underpinning the crisis will require an aggressive and prolonged investment by the state and federal governments.

“It’s taken us years to get to this point, and it will take time to fix it,” she said.

Lawmakers are considering a number of proposals to address shortages, low reimbursement rates and other mental health care issues, all of which are inching along through the legislative process.

Rep. Paul Tucker, D-Salem, a member of the Legislature’s Committee on Mental Health, Substance Abuse and Recovery, said he is “shocked” at how difficult it is to find treatment beds for young people seeking psychiatric care.

He said lawmakers understand the urgency of expanding youth mental health services.

“We need to be doing everything we can or the situation will get worse,” he said.

Christian M. Wade covers the Massachusetts Statehouse for North of Boston Media Group’s newspapers and websites. Email him at

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