More than four in 10 teens report feeling "persistently sad or hopeless" during the COVID-19 pandemic, according to a survey published Friday by the Centers for Disease Control and Prevention. Girls were twice as likely to experience mental health troubles compared to boys. And LGBTQ students were hit the hardest. 

The CDC's findings were gathered from online surveys from a sample of 7,700 US students during the first six months of 2021. The questions presented were about mental health, drug use and violence at home or school.

The stress and adversity of the pandemic were not limited to just adults; teens and children felt it too. "It's no secret that kids are going through a lot right now. Knowing how to spot the signs of something more serious is vital," says Barb Solish, director of youth and young adult initiatives for the National Alliance of Mental Illness.

The survey suggests, however, that school can act as a protective layer for students and their troubles. Here's what to know.

44% of students reported feeling persistently sad or hopeless

Teen mental health has been top of mind as rates of depression, anxiety and loneliness have increased in kids. During lockdown, emergency room visits among adolescent girls for attempted suicide increased by nearly 51%. 

"Approach suicide prevention and mental health in the same way you do with other safety or health issues for your children, by providing information, opening the door for questions and dialogue and reassuring them that help is available," says Dr. Christine Moutier, chief medical officer at the American Foundation for Suicide Prevention. "It is important to have these conversations before your child is a teen and to not be afraid to ask directly about suicide if you are concerned."

These CDC findings are the newest cause for concern on a persistent issue. The American Academy of Pediatrics declared a national emergency for child and adolescent mental health in October. Even before the pandemic, mental health concerns have been an ongoing battle for parents. Reported "persistent feelings of sadness or hopelessness" in teens rose from 26% in 2009 to 37% in 2019. The figure hit an all-time high in 2021 at 44%.

LGBTQ students were most affected

The pandemic affected all students, though the impact was more severe for some. The survey found higher levels of vulnerability among LGBTQ students, with worse mental health and more suicide attempts found. Nearly 50% of gay, lesbian and bisexual teens reported they considered suicide during the pandemic. 

Mental health issues in the LGBTQ community have always been a concern. Previous research suggests that members of the LGBTQ community are at a higher risk for depression and anxiety disorders. A 2020 study found that transgender youth are twice as likely to experience depressive symptoms and consider or attempt suicide. 

Many students reported emotional abuse and racism

The pandemic was a time of emotional distress for everyone. It limited kids to their home -- which wasn't always a safe place. A quarter of the students said that at least one parent lost a job due to the pandemic. As a result, 55% of students said they dealt with put-downs and other forms of emotional abuse from a parent. 11.3% said they experienced physical abuse. Rates of abuse were the highest among those who identified as gay, lesbian or bisexual.

Part of the CDC survey asked about treatment in school based on race or ethnicity. 64% of Asian American students reported feeling like they were treated poorly or unfairly. Black and multiracial students were the second-highest, with 55% reporting a racist encounter at school. Students said that these encounters made it hard for them to concentrate on school and also reported more mental health problems. 

School is crucial for kids' mental health

Virtual school was tough on kids, as anyone who went through it knows. It compromised their ability to connect with their teachers and other students. 66% of students said they had difficulty completing assignments during lockdown. 

School is a crucial time for kids to feel connected. A silver lining is how schools could play a positive role in teen mental health. Mental health levels were higher in teens who felt connected. While virtual school made it difficult, students who could virtually connect with friends and family did fare better. 

Mental health resources in school are essential to ensure that the burden of speaking up does not fall on children. As a part of the strategy to address the national mental health crisis, the Biden administration pledged $85 million in funding for schools to use for mental health awareness training and treatments.

Don't wait to talk to your kids about their mental health

Talking to your children about mental health topics is difficult. To start, you should pay attention to any changes in their behavior. The changes can be small --  the things they say, their grades or their interactions with friends and family members. 

"All kids experience 'bad days' now and then, but if their negative emotions, thoughts or behaviors are getting in the way of their everyday functioning, it is important to take notice and take action," Solish says. 

Sudden changes in your teen's behavior signify that they may need help. Communication is essential. You want to be straightforward and ready to listen to what they have to say.

"Make sure that communication is open by approaching them with statements that indicate you are aware that many teens are concerned about their mental wellness. Car rides are good times to have conversations," says Mary K. Alvord,  a psychologist and co-author of Conquer Negative Thinking for Teens and Resilience Builder Program for Children and Adolescents. "I also suggest that parents ask their teens about what they value and what is most important to them now. It's a positive way to get a conversation going and that can then be explored in more depth."

As always, know when they need help that you can't give them. If you suspect your teen is having difficulties or they won't open up to you, encourage them to talk to a school counselor or a doctor. 

"While mental health professionals are a key resource, it's important to note that everyone has a role to play in suicide prevention," says Moutier. "Having an open, authentic conversation about mental health with someone can be the first important step in staying connected for yourself or someone else and helping get support or treatment if needed."

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.