A youth mental health crisis was already brewing. The pandemic made it worse, surgeon general says.

The situation painted across the U.S. surgeon general’s 53-page advisory is dire.

Compared with 2019, emergency room visits for suicide attempts rose 51 percent for adolescent girls in early 2021. Among boys, there was a four percentage point increase. Depression and anxiety doubled during the coronavirus pandemic, with 25 percent of youths experiencing depressive symptoms and 20 percent suffering anxiety symptoms, according to the report published Tuesday.

“It would be a tragedy if we beat back one public health crisis only to allow another to grow in its place,” U.S. Surgeon General Vivek H. Murthy wrote in an advisory published on Tuesday. “Mental health challenges in children, adolescents, and young adults are real, and they are widespread. But most importantly, they are treatable, and often preventable.”