The pandemic is taking a toll on children's mental health. We need to prioritize returning them to the classroom.

• While children are less likely to get COVID-19 or have a severe case, they are suffering from the effects of the pandemic. 
• A recent study shows that more children are facing symptoms of mental illness since the pandemic erupted, and fewer parents are seeking treatment or think treatments are effective. 
• Lawmakers need to recognize the impact of school closures on kids and prioritize returning students to classrooms. 
• Dr. Laura Luzietti is a pediatrician and executive director of Every Child Pediatrics, a nonprofit safety-net practice that serves over 23,000 children in Colorado. Will Johnson is CEO of The Harris Group, one of the world's leading public opinion research and analytics firms.
• This is an opinion column. The thoughts expressed are those of the authors. 
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As the coronavirus rages across the US like a continental wildfire, one group seems to be mercifully spared: school-aged children.

While K-12 kids make up 16% of the US population, they have accounted for just 4% of all COVID-19 cases. To date, only 219 children under 18 have died from the virus, the Centers for Disease Control and Prevention says in a recent report, or less than 0.09% of the pandemic's death toll, which has now topped 370,000 nationally.

But while children experience less severe illness than adults, they are still suffering from COVID-19's harmful effects. In a new survey by the Harris Poll, parents say many symptoms of mental illness have increased among their school-aged kids since the pandemic erupted last March. Parents describe one in eight of their children's mental health as poor or fair today. Even so, fewer parents say they're seeking mental health treatment for their children. Fewer also say treatment seems effective.

School-age children are feeling the effects of the pandemic

As a pediatrician and a pollster, we know from our work that the overwhelming majority of parents are doing what they can to protect their children from harm. And as parents of school-aged children, we recognize that despite our best efforts, we are unable to shield our children entirely from the stress and disruption caused by the pandemic. COVID-19 damages people's well-being, whether they're 50 or, as this survey confirms, 15 or five.

Even during "normal" times, of course, some share of children suffered from anxiety, depression or other mental health disorders. Parents in our survey say that before the pandemic, at least 10% of their school-aged children showed mental health symptoms such as eruptions of anger, difficulty concentrating or forgetfulness, lethargy, fear and headaches. The behaviors were most prevalent in households with incomes under $50,000 a year.

But because of the coronavirus, little today is normal. According to our survey, only 16% of children 18 years old or younger are back in school this fall; the rest are socially isolated, being taught at home or in hybrid programs of remote and in-classroom instruction. 

School disruption is only one of the coronavirus-related stressors faced by children. During the pandemic, 10% of school-age children had a COVID-19-related death in the family, 18% had a parent lose a job, and 45% had parents suffer a drop in income. One in nine children has experienced psychological abuse and a quarter have faced food insecurity. These percentages are highest in households with pre-K children.

Kids' mental health is deteriorating

Despite such hardships, two-thirds of children had parents who say their children's physical health is very good or excellent. Their mental health, however, is deteriorating. Barely half of children had parents who consider the mental health of their children to be very good or excellent right now, while 13% are in fair or poor condition.  

More school-age children are exhibiting signs of mental illness, too, and those affected have a broader range of symptoms. Since COVID-19 hit, according to their parents, one in seven kids has been quick to anger, has trouble concentrating, and has low energy. And at least 10% worry constantly, have reduced interest in everyday activities, procrastinate or neglect duties, have reduced interest in relationships or social interactions, have difficulty sleeping, are more sensitive to rejection or failure, have headaches, have nervous habits like nail-biting, are sad frequently, and clingy. Again, these behaviors are most common in poorer households, where over 40% of children display many of these troubling symptoms.

Before 2020, 18% of children had parents say they sought counseling or therapy for their children's disorders, and 17% had parents say their children were prescribed medications. Half had parents who thought therapy was extremely or very effective then, and 61% had parents who believed medications were extremely or very effective, with only 6% of children's parents calling medications not very helpful and none saying it was of no help. 

Today, 17% of children are in counseling or therapy and 14% are being treated for mental illness with medication, based on our survey of representative American adults. Half of children's parents think therapy is still an extremely or very effective treatment for the kids, but 11% of children now have parents who say it is not very or not at all effective. The share of children whose parents say medication is extremely or very effective has slipped to 59%, while one in 10 now have parents who say drug treatment is not very effective or doing no good at all.

So what do we do about this? 

As the Biden administration, together with state and local governments, weigh whether to close or open parts of our economy, decision-makers need to recognize the impact of school closures on the well-being of our children and prioritize returning children to the classroom, to reduce the social isolation that surely is exacerbating children's mental health issues. Mental health care, as a vital component of pediatric health care, must be made available to all children across the country.  

Most important, parents need to recognize the risks that the pandemic poses for their kids, no matter how carefully they've been shielded, or how little or grown-up they are. And if parents see symptoms of mental illness in their children, they need to seek help for them. A good first step for many families would be to schedule a telehealth appointment with their general pediatrician. 

As parents and as a society, we must do all that we can to protect the mental and physical health of our children while we wait to move on to a post-COVID-19 way of life.

• Read more:
• I'm a psychiatrist who's worked with long-term mental health service users throughout COVID-19. Here are my 7 strategies to reduce anxiety during the pandemic.
• We need talk about our mental health crisis before the worst of COVID winter hits

Dr. Laura Luzietti is a pediatrician and executive director of Every Child Pediatrics, a nonprofit safety-net practice that serves over 23,000 children in Colorado.

Will Johnson is CEO of The Harris Group, one of the world's leading public opinion research and analytics firms.