Directors of mental health clinics and day programs for children and adolescents in Israel reported a 71.2% increase in referrals of patients with serious suicidal thoughts during the second wave of the novel coronavirus pandemic (August-October) compared with the first wave (March-May). There was also a general decline in the condition of many patients previously in treatment, according to a report from the Mental Health division of the Health Ministry released Wednesday.The report revealed that the directors had seen an 81% increase in new referrals during the second wave, as well as an increase in the severity of the problems of patients who had previously been in treatment, including those from single-parent families, as well as among children in special education and in boarding schools.Dr. Udi Sasser, the director of the clinical department at the Mental Health Division, and Dr. Danny Budowski, director of outpatient services, wrote the report after they received responses at the end of October from 31 mental health directors, 23 of whom run clinics and eight of whom run day programs.The most alarming finding in the survey was the increase in suicidal ideation among patients. Almost 39% of patients reported some increase in suicidal thoughts, while another 32% said that they had had a meaningful increase in suicidal thinking. Given that it generally takes between eight months to a year before newly referred patients can see a therapist, the high numbers of suicidal children and adolescents seeking care is worrisome.While the authors of the report wrote that there was a decrease in referrals during the first wave, in the second wave, they said that there was a marked increase in referrals for all issues, as well as in the severity of problems in patients with anxiety, mood disorders and eating disorders.They also found that about 60% of patients reported an increased need for parental supervision and involvement during the second wave. This increase was reported in children and adolescents from all single-parent and traditional families.The doctors concluded the report with a clear call to increase the availability of mental health services for children and adolescents, writing: “In view of the long waiting times even before the outbreak of the plague alongside the findings of this survey, there is an immediate need to increase the outpatient services for children and youth to address the significant increase in referrals.”