It feels like a never-ending nightmare
In the long arc of American childhood, the pandemic year of 2020 will be remembered as a rupture — a moment when millions of young people were severed not only from classrooms and friends, but from the invisible scaffolding of adults who watch, notice, and intervene. By early 2021, emergency rooms, school counselors, and grieving families were bearing witness to what prolonged isolation had quietly done to children's inner lives. The crisis was not viral but existential — a generation asked to endure adult-scale loss without the tools or the company to carry it.
- Emergency room visits for children in mental health crisis surged up to 31% in 2020, and suicide attempts among teenagers grew not only in number but in severity and intent.
- In Clark County, Nevada, nineteen students died by suicide in less than a year — more than double the previous year's toll — putting a human face on statistics that were rising across the country.
- Children lost access to the teachers, counselors, and coaches who are often the first to notice depression and anxiety, leaving warning signs unseen and support systems unreachable.
- Schools began reopening in early 2021, but experts cautioned that returning to buildings would not undo the accumulated psychological damage without direct, sustained mental health intervention.
By February 2021, American childhood had quietly fractured. Nearly a year into the pandemic, millions of students had traded classrooms for screens, surrendering the rituals — sports, proms, hallway conversations — that stitch adolescence together. What emerged in their place was a mental health emergency that doctors, parents, and government agencies could no longer ignore.
Sarah Frank, eighteen, had not left her home since March 2020, sheltering to protect vulnerable relatives. The isolation was suffocating. "It feels like a never-ending nightmare," she said. Rather than collapse inward, she co-founded the State of Mind Project, a resource hub for teenagers — because she understood that her suffering was not singular.
Deanna Caputo, a psychologist and mother in Arlington, Virginia, watched her ten-year-old son retreat into himself after his school went virtual. He slept until noon. He told her he was not smart, not good at anything. Caputo heard the same story from families around her — parents scrambling for therapists who no longer had openings, children starting medication because talk therapy had become impossible to access.
The numbers confirmed what families were living. Emergency room visits for mental health crises rose 31% among adolescents and 24% among younger children compared to 2019. Pediatric emergency physician Susan Duffy of Brown University put it plainly: for adults, the pandemic was a medical crisis; for children, it was a mental health one. The suicide attempts she was seeing were more deliberate, more dangerous.
The pandemic had done something structural as well as emotional — it had removed the adults outside the family who are trained to notice when a child is slipping. Teachers, coaches, school counselors disappeared from daily life precisely when they were most needed. Layered onto this were unemployment, food insecurity, and the fear of losing a parent, all pressing down on young shoulders.
Schools were beginning to reopen by early 2021, but unevenly, and experts warned that unlocking the doors would not unlock what had closed inside children. Anxiety and depression, Duffy noted, do not dissolve with a change of setting — they find new shapes. The work of repair, it was clear, had barely begun.
By February 2021, something had shifted in American childhood. Millions of students had spent nearly a year staring at computer screens instead of sitting in classrooms. They had not attended football games or proms. They had not played sports or taken music lessons in person. They had not seen their friends except through a glowing rectangle. And now, doctors, teachers, parents, and government agencies were sounding an alarm: the children were breaking.
Sarah Frank was eighteen years old and had not left her home since March 2020. She lived with relatives who were medically vulnerable, and the risk of bringing the virus inside was too great. The loneliness was crushing. "I have days I feel really sad, and a bit hopeless," she told reporters. "It feels like a never-ending nightmare." She had missed her high school experiences entirely—no football games, no prom, no ordinary rituals of adolescence that she would never recover. In July, she co-founded the State of Mind Project, a website offering mental and physical health resources for teenagers, because she knew she was not alone in her suffering.
Deanna Caputo, a psychologist and mother of two, watched her ten-year-old son deteriorate after his Arlington, Virginia school went virtual in March. He would wake in the morning and return to bed until noon. His mood darkened. He began telling her things like "I am not smart" and "I'm not good at anything." Caputo knew other children in worse condition. "All I hear is about medication starting," she said. "They can't find therapists" because demand had overwhelmed the system. Brandon, a thirteen-year-old in the same district, had attended remote-only classes for more than three hundred days. "There's almost no motivation into wanting to do online school," he said.
The numbers were alarming. Between March and October 2020, hospital emergency room visits for mental health crises among children aged twelve to seventeen jumped thirty-one percent compared to the same months in 2019. For children aged five to eleven, visits climbed twenty-four percent. In Clark County, Nevada, which includes Las Vegas, nineteen students had taken their own lives since March—more than double the nine deaths recorded in the same period the year before. Teenage suicide rates had been climbing in America for a decade, but the pandemic appeared to be accelerating the trend.
Susan Duffy, a professor of pediatrics and emergency medicine at Brown University, drew a stark distinction: for adults, the coronavirus had been a medical crisis. For children, it was a mental health crisis. She and colleagues at hospitals across the country were documenting more suicide attempts among young people, and the attempts were more serious. "We're seeing more kids with intent to hurt themselves," Duffy said. "It's more associated with actually carrying out suicide attempts, which is very, very worrisome."
The pandemic had severed children from the adults outside their families who might notice when something was wrong. Teachers, counselors, coaches—the people trained to recognize the subtle signs of depression and anxiety—were no longer present in their daily lives. School closures, unemployment, food insecurity, housing instability, and the fear of losing a family member to the virus all layered onto children's shoulders. The CDC warned that pandemic stress was increasing the risk of child abuse as well. "When parents lose hope they go into abuse behavior, drinking and physical abuse and emotional abuse," Caputo said.
By early 2021, schools were beginning to reopen, though unevenly. About thirty-eight percent of schools remained remote-learning only, down from sixty-two percent in September. But reopening alone would not solve what had been broken. Some children who had been bullied might have found refuge in online learning, but the underlying anxiety remained. "Anxiety and depression are still there," Duffy noted, "and then they're manifesting themselves in different ways." The pandemic had not simply isolated children from school. It had isolated them from the systems of care and connection that held them upright.
Notable Quotes
I have days I feel really sad, and a bit hopeless. It feels like a never-ending nightmare.— Sarah Frank, 18-year-old from Florida
For adults, the coronavirus has been a medical crisis. For children, it has been a mental health crisis.— Susan Duffy, professor of pediatrics and emergency medicine at Brown University
The Hearth Conversation Another angle on the story
What made this moment different from other periods when kids struggled with mental health?
The scale and the simultaneity. Millions of children were removed from their support systems all at once—not just school, but the entire infrastructure of connection. Teachers, coaches, counselors, friends. All gone.
But couldn't some kids actually prefer remote learning? Especially the ones being bullied?
Yes, and that's the trap. A few kids found temporary relief. But the underlying conditions didn't disappear. The anxiety and depression were still there, just hidden. And without adults watching, without the structure of in-person life, some kids spiraled in ways no one could see.
The numbers from Nevada are striking—nineteen deaths in one county. Can we really blame the pandemic for that?
The authorities couldn't draw a direct line, but they didn't need to. The timing was unmistakable. And it wasn't just suicide. Emergency rooms were flooded with kids in mental health crises. The pandemic didn't create these vulnerabilities, but it amplified them.
What about the teachers' unions refusing to go back? Were they wrong?
That's where the story gets complicated. The unions had legitimate safety concerns. But the cost of keeping schools closed was being paid by children in ways that weren't visible in the headlines—not in hospital admissions, not in the ones who didn't make it.
So what happens now? Schools are reopening.
The reopening is uneven and incomplete. But more importantly, the damage is already done. The kids who lost a year of their lives, who attempted suicide, who developed depression—they don't just recover because classrooms reopen. The crisis didn't end when the doors unlocked.