Plenty of news stories over the past two years have highlighted the mental health toll of the pandemic on all different kinds of groups—healthcare workers first and foremost, but also parents of school-age children, teachers, low-wage workers, and adolescents. Of course, it’s hard enough to make it through the teen years when there’s not a raging global pandemic (or a long-overdue reckoning with US racism, or a rapidly warming planet with worsening catastrophic weather, or the hints of a World War III in the Ukraine-Russia war, or any of the other major stressors of the past few years). But Covid-19 took an already existing public health crisis and flooded that fire with a tsunami of gasoline, according to an extensive CDC report just released on adolescent mental health.

Teenagers were already struggling more than in past years before the craziness of 2020 took over. An adolescent mental health crisis had been going on for almost a decade in the US. Still, it was flying under the radar for everyone except the parents and teachers seeing it for themselves every day (and the teens living it). After reaching a peak in the early 1990s, teen suicide rates began steadily declining until about two decades later, when they started climbing again around 2010 or so.

A comparison of 2009 and 2019 data from the CDC reveals the stark differences: Suicide attempts among US high school students increased more than 40% during this time, from 6.3% in 2009 to 8.9% in 2019. Injuries from suicide attempts increased by more than 50%, from 1.9% in 2009 to 2.5% in 2019. Similar trends were seen among those who considered suicide or made a plan. While just over a quarter of high school students felt “persistent feelings of sadness and hopelessness” in 2009, that number had shot up to more than one in three teens (36.7%) in 2019.

So it’s not remotely surprising that a global pandemic that substantially interrupted school, college plans, social lives, and the social fabric as a whole—not to mention loved ones lost to the disease—would make the teen mental health crisis even worse. And that’s exactly what the latest CDC shows. More than one in three high school students reported poor mental health during the pandemic, and just under half (44%) said they felt consistently sad or hopeless during the past year.

The new CDC findings come from an online survey conducted from January to June 2021 among 7,705 high school students who answered 110 questions about everything from accidental injury, self-harm, bullying, violence, and suicidal thoughts to smoking, alcohol and drug use, sexual behaviors, and diet. The questions asked not only about individual respondents’ behaviors but also about their perceptions of their peers’ behaviors during the pandemic.

The students were about evenly divided among freshmen, sophomores, juniors, and seniors, and self-identified sex was split 50/50. Half the students were white, a quarter were Hispanic, 13% were Black, 5% were Asian, and 6% were multiracial. Three out of four respondents identified themselves as heterosexual, 13% identified as LGBT, and 9% said they were “other or questioning.”

Among the 128 schools that participated from across the US, three out of four had a hybrid instructional mode (a mix of in-person and online instruction). At the same time, 22% used only online education, and 3% used only in-person instruction. Notably, the responses only reflect those teens who were enrolled in school and not those who were homeschooled or in alternative arrangements, which was about 5% of all teens aged 14 to 17 in 2018 and probably higher during 2021.

Since the survey is cross-sectional, showing us just a snapshot in time, it can’t show cause and effect, but it does tell us just how bad the problem is: 37% of high school students had poor mental health during the pandemic. Moreover, the 44% who “persistently felt sad or hopeless during the past year” is a 6-point increase from the 37% reporting that in 2019.

One set of findings addressed abuse that teens experienced at home during the pandemic. More than half (55%) said they experienced emotional abuse by a parent or another adult in their household, which could include being cursed at, insulted, or put down. One in ten (11%) experienced physical abuse. Perhaps adults’ stress played a role in this since nearly a third of teens (29%) said their parents or another adult in the home lost their job during the pandemic.

Fortunately, the CDC report revealed protective factors, too, especially feelings of connectedness with peers and teachers at school. More than half the teens who didn’t feel connected to people at school (53%) felt persistently sad or hopeless, compared to just over a third (35%) of those who did have that sense of connection at school. In addition, a quarter of those who didn’t feel connected (26%) had suicidal thoughts, compared to 14% who felt that sense of connection, and actual suicide attempts were twice as high (12% vs. 6%) in those who lacked a sense of belonging at school. The problem was that so many—nearly half of those surveyed (47%)—said they didn’t feel close to people at school during the pandemic.

The complete CDC report goes into much more detail, but the takeaway from its 40 pages isn’t much different than what’s above: teens are in crisis, and neither the medical system nor the country are meeting their needs. It’s a systemic problem that will take big-scale policy initiatives to address. Still, one thing anyone can do, regardless of their career, is let their representatives know it’s long past time to prioritize children’s and teens’ mental health in this country. If those who are training to take over in just a few decades continue to fare so poorly, that doesn’t bode well for where our nation will end up.