The country was already seeing a rise in anxiety and depression rates among teenagers and older children before the pandemic. Then the added stressors of COVID-19 and the resulting isolation made things much worse.

Connection is a huge part of child development, so a lack of it is “catastrophic,” Ali said.

In early 2021, Gov. Jay Inslee issued an emergency proclamation to health care workers, schools and others to start addressing the problem, Hammer said.

Parents play a key role. They know their kids and see their development up close. They can also see signs that help is needed, Hammer said.

Ali suggested watching for what is new, what is rapidly changing and what the child seems unable to properly express.

Some signs a child may need help are new headaches, fatigue or change in appetite. Others are major mood changes, difficulty concentrating, loss of interest in regular activities and cutting off friendships, Ali said.

The best way to find out what is going on with a child is just to talk to them with curiosity and without judgment, Ali said.

Something simple like sharing a meal or going for a walk with someone can help people connect and make a world of difference, Hammer said.

Depression, anxiety and behavioral outbursts are more common in older children and adolescents because they have more of a sense of what’s going on in the world. Yet adolescents are also less likely to ask for help in times of unrest.

COVID-19 has also strained the health care system. People needing appointments through primary care and psychiatry are seeing longer wait times. So are students who are looking for help in schools, Daly said.

Waiting too long for help can lead to crisis.

Visits to the Emergency Department have gone up substantially in the last few years, Daly said. That’s true at Island Health and across the state. Teenagers are coming in with panic attacks, suicidal ideations or attempts and suspected overdoses.

Island Health is looking at recruiting more staff, including three new therapists (two at the psychiatry clinic and one in the schools), but staffing can be a major challenge, Daly said.

With school collaboration, Island Health is looking at implementing new programs, such as group interventions that can help with connection and isolation issues, Castro said.

People often worry not only about what others will think if they seek help but what that means for themselves, Hammer said.

But such issues are common and can be even more likely among people facing a wide range of risk factors.

Those factors can include early puberty, head injury, emotional or physical trauma and low self-esteem or perceived importance, Castro said. Risk factors can exist inside a family, such as parental depression, family conflict and a negative environment. School- and community-based risk factors include peer rejection, stressful events, poverty, loss of a close relationship and peer pressure through social media.

The panel touched on social media’s effects on mental health — both negative and positive.

Social media can have detrimental effects on both youths and adults, particularly with misinformation distributed and the time it takes that could be used elsewhere, Castro said.

However, Ali noted that young people, in particular, rely on social media as a way to connect with each other. So banning it could be problematic.

People inherently seek connection, he said. People want to be seen and heard, and social media provides a platform for that.