NEW YORK -- As the pandemic wanes, experts advised it's important to recognize the impact of the fear, loss and isolation it caused on children's mental health.

Data from the Children's Hospital Association showed between April and October last year, hospitals saw a 24% increase in mental-health emergency visits by kids ages five to 11, and for ages 12 to 17, the increase was 31%.

But parents may not always recognize the symptoms of trauma and grief.

Dr. Shea Lott, lead clinician for the Steven A. Cohen Military Family Clinic at Easterseals, pointed out in a webinar on "Helping Our Children Navigate Through Trauma," children experience grief differently than adults.

"For children, you typically will get a lot of physical symptoms, like headaches, stomachaches, and those kinds of things; not wanting to do things that they usually enjoy," Lott outlined.

New Yorkers can find resources for helping children and families cope with COVID-related stress and trauma through the New York State Office of Mental Health, online at nyprojecthope.org.

Dawn Khan, a parent of two teenagers in Manhattan, said she began to notice changes in her 15-year-old daughter's behavior and outlook last summer.

"She's definitely exhibited signs of depression," Khan observed. "Her interpersonal relationships have suffered; she's much more withdrawn than she used to be."

She added her daughter has been seeing a therapist, and with schools reopening, she is beginning to reengage socially and appears to be happier.

Vicki Jay, CEO of the National Alliance for Grieving Children, noted the upheaval of the pandemic has impacts that will last a lifetime, and it has affected everyone.

"We've all experienced loss and change, and disappointment and trauma, this year," Jay recounted. "And it's not going to be over with; there's not a switch to flip. It becomes a part of who we are, and it's what we take forward with us."

In a recent poll by the American Psychiatric Association, 48% of parents said the pandemic has contributed to mental-health problems for at least one of their children.

As the school year winds down, education leaders are shedding light on increased mental-health demands among students, including thoughts of suicide.

Various organizations in Iowa also are calling attention to the issue during Mental Health Awareness Month.

Lisa Cushatt, executive director of the trauma healing group Iowa ACES 360, said concerns were building prior to the pandemic, but adds the crisis has added layers of mental health issues for children and adolescents.

She said what's happening now shatters the myth that kids are born resilient, especially when adults in their lives feel extra stress simultaneously.

"We want to believe kids are born resilient," said Cushatt. "But we have such a responsibility as adults to help cultivate that and model that and it's really hard to do when we're in crisis ourselves."

According to new Centers for Disease Control and Prevention data, 44% of U.S. high school students recently reported persistently feeling sad or hopeless in the past year. And nearly 20% had seriously considered attempting suicide.

Last month, the U.S. Preventive Services Task Force recommended screening for anxiety in youths between the ages of 8 and 18.

While school counselors are responding to more referrals, there are calls to enhance training for all staff to help these students. Those suggestions coincide with gaps in locating enough providers who can help a child away from campus.

Erin Drinnin, community impact officer for health of the United Way Central Iowa, said Iowa Children's Behavioral System is feeling the impact of the workforce shortage.

"How do we recruit enough mental-health professionals to go into school," said Drinnin, "to go into these professions to serve youth and adults?"

The Coalition to Advance Mental Health in Iowa for Kids recommends actions such as student loan forgiveness and maintaining telehealth flexibilities.

Julia Webb, program director for NAMI Iowa, said parents and educators can be proactive by intervening when warning signs pop up.

"If you're seeing a young person isolating themselves," said Webb "not taking joy in the things they've previously found happiness in, ending relationships with friends, not wanting to interact with friends."

For crisis situations, signs include expressing great shame and plans that point to ending their life.

May is Mental Health Awareness Month and advocates are hoping Gov. Gavin Newsom will prioritize the issue in his revised budget, due by Sunday.

The governor's January budget proposed $4.7 million to fund the California Parent and Youth Helpline annually for three years. The helpline connects people with a trained counselor for free from 8 a.m. to 8 p.m., seven days a week.

Dr. Lisa Pion-Berlin, president and CEO of Parents Anonymous, which runs the California Parent and Youth Helpline, said additional funding is needed to keep up with demand for their services.

"With greater resources, we could have more trained clinicians to answer the phone," Pion-Berlin explained. "The demand outstrips our capacity right now. We have people on waiting lists to get into our free online weekly support groups."

The service has helped more than 40,000 people in California since it started two years ago, but they would like to help more of the Golden State's 9.3 million children.

Last week was Children's Mental Health Acceptance Week, when people are encouraged to take action and reach out to another person who might be struggling. Pion-Berlin emphasized no one should be blamed or shamed when they ask for help.

"Parents need support in identifying and accepting that change in behavior, mood swings, sleeping patterns, change in friends, that their child looks sad, and that they may need to seek help," Pion-Berlin outlined.

A 2021 study in the Journal of the American Medical Association found child suicide rates have been rising in recent years, and suicide is the 8th leading cause of death among children aged 5 to 11.

Marking Mental Health Awareness Month, advocates contended more outreach and services are needed to help West Virginia caregivers with their mental health, which can lead to increased anxiety for children and other difficulties for families.

In addition to May's focus on mental health, this week also highlights Children's Mental Health Awareness, underscoring positive mental health is essential to a child's healthy development.

Global nonprofit Save the Children works to increase mental-health programs in the Mountain State.

Erika Blackburn, lead associate of community engagement in West Virginia for the group, said while more than a third of the state's adults recently reported persistent anxiety -- placing West Virginia in the top three states across the nation -- children face the same problem in their own lives, as well as by modeling their parents and caregivers.

"A lot of the options that were presented to others across the country during the pandemic were difficult for a lot of our children because of the lack of connectivity," Blackburn pointed out. "There's certainly areas where we work in West Virginia that do not have reliable internet."

Blackburn said Save the Children's social and emotional learning program, Journey of Hope, helps around 500 children across 10 West Virginia school districts to explore and understand their emotions, develop healthy coping skills and build resilience for future challenges.

Blackburn added the COVID pandemic, and subsequent interruptions to their normal routine, only exacerbated the mental-health challenges children already face in the state.

"Exposure to a lot of trauma from the opioid crisis, and just being away from their teachers and the child-serving professionals that are too often the only source of love and support some children receive," Blackburn emphasized.

Greta Wetzel, senior adviser of psychosocial support for Save the Children, said the problems West Virginia faces often are the same as other states with large rural populations.

"In our rural communities, you might have one mental-health facility for the whole county that could be an hour drive away from you, or one social worker that covers the entire school district," Wetzel outlined.

Wetzel noted Journey of Hope programs also offer services for caregivers, explaining while adults are often focused on the needs of children, they need to take moments for themselves.