At a virtual rally on Sunday, parents, young people and advocates in the city and across the state shared stories about the impact of the pandemic and renewed calls for elected officials to invest more in behavioral health programs and services for children and teens, which experts say have been underfunded for years and are now at a breaking point, with increased demand spurred by the coronavirus crisis.

As a new school year kicks off next week—the third since the pandemic began—local advocates and families are calling for New York lawmakers to prioritize mental health resources for youth, pointing to the impact of COVID-19 on a system they say was strained across the state well before the crisis.

At a virtual rally on Sunday, parents, young people and advocates in the city and across the state shared stories about the impact of the pandemic and renewed calls for elected officials to invest more in behavioral health programs and services for children and teens, which experts say have been underfunded for years and are now at a breaking point, with increased demand spurred by the coronavirus crisis.

From 2016 to 2020, the percentage of New York children aged 3-17 who were diagnosed with anxiety and depression increased from 8.9 to 10.9 percent, according to a recent report from the Annie E. Casey Foundation. New York was 29th out of the 50 states in the group’s annual ranking this year—which looked at indicators related to the economy, education and health—landing among the states categorized as “worse” for overall youth well-being.

Advocates cite an ongoing shortage of mental health care providers and specialists, which they say can mean months-long waits for those in search of care and families forced to turn to emergency rooms and hospitals during times of crisis. For more than 2 million low-income children enrolled in the state’s Medicaid program, a redesign promised years ago that was supposed to replace inpatient beds with community-based behavioral health services failed to fully materialize, prompting a class action lawsuit filed against the state this spring.

“New York administers an inadequate, inaccessible, and dysfunctional mental health system for children and youth,” the organizations representing the plaintiffs in that case said alongside the complaint filed in March, which accuses the state of “denying Medicaid-eligible children their legal right to community-based mental health services.”

READ MORE: Years After NY Medicaid Overhaul, Kids’ Access to Mental Health Care Still in Crisis

Even before the pandemic, more than half of New York youth in need of treatment for a mental/behavioral condition did not receive it in 2017, according to National Survey of Children’s Health that year.

“COVID-19 has taken a crisis that was there and just made it even harder for families and children,” Alice Bufkin, executive director for policy and advocacy at the Citizens Committee for Children (a City Limits funder), said during Sunday’s rally. The situation, Bufkin said, has “parents who are searching for mental health providers that just aren’t there, and young people who don’t know where to turn.”

“Children’s behavioral health needs to be a priority for state leaders,” Bufkin said. “It’s personal. It’s political, and it’s something that cannot be ignored anymore.”

On the local level, advocates and elected officials point to city schools as a major resource and entry point to care for students experiencing a mental health crisis, but say more should be done to expand that access as well as training for teachers and staff.

During the 2020-2021 school year, a period marred by the anxieties of the COVID-19 crisis, associated classroom closures and remote learning, more than 400 New York City public schools lacked a single social worker, according to a recent audit by New York State Comptroller Tom DiNapoli.

The audit found that only 1,101 out of 1,524 public schools had at least one social worker that year, and of those that did, 80 percent did not meet the recommended social-worker-to-student ratio of 1:250. When it comes to guidance counselors, 1,422 out of 1,524 city schools had at least one during the 2020-2021 school year, though more than half of these did not meet the recommended counselor-to-student ratio, the comptroller found.

The Department of Education, in response, said the audit’s data was “out of date,” saying there are now approximately 5,000 social workers and guidance counselors working across the city’s school system, an increase of 1,000 since 2014.

“Currently, every NYC public school student has access to a counselor, social worker, or school-based mental health clinic,” a DOE spokesperson said in a statement. “Our commitment to supporting our students and school communities through difficult times and beyond is unwavering.”

But Napoli’s office called for additional changes, including that the DOE mandate all school staff who interact with students daily undergo mental health training. While the DOE offers a plethora of these kinds of programs to employees, they’re optional, and the comptroller’s office found that attendance was low at the training sessions it checked in on during its audit.

“Given the shortage of professional staff, mental health awareness training of all staff would be a valuable ‘first line of defense’ to identify signs of mental health struggles among students,” the audit report states.

Allison Hollihan, director of the NY Initiative for Children of Incarcerated Parents at the Osbourne Association, said she’s seen firsthand how the pandemic has exacerbated mental health issues among the young people they work with.

“There’s starting to be more money put towards social workers in schools, but there just still isn’t enough,” she said. “I still hear from young people all the time that the only time they’re able to access social workers or guidance counselors in the New York City public school system is when they when they get in trouble. And they’re like, ‘We shouldn’t have to have a crisis or get into trouble to get help. We should be able to access before a crisis occurs.'”

Her group works specifically with young people who have parents or family in prison in jail. That and other incidents of trauma can have lasting impact on a child’s mental health if they aren’t provided with the support and care they need, she said.

“It’s really critical that that we’re intervening and providing supports to mitigate these long term effects because we know with support, children can thrive,” Hollihan said. “They’re not destined to develop these long term outcomes, but we have to be there to support them to make sure that doesn’t occur.”

City Limits’ series on behavioral health and NYC’s children is supported by the Citizens’ Committee for Children of New York. City Limits is solely responsible for the content and editorial direction.