Suicide attempts surged among 12- to 17-year-olds, especially adolescent girls, during the Covid-19 pandemic and got worse the longer social distancing orders and government lockdowns persisted, according to new data from the Centers for Disease Control and Prevention.

Emergency department visits at hospitals among adolescents were already increasing in early May 2020 when the pandemic was spreading across the U.S., the CDC said in a study released Friday. From late July to late August 2020, the average weekly number of emergency department visits for suspected suicide attempts among 12- to 17-year-old girls increased by 26.2% from the same period a year prior.

The disruption of daily life with pandemic lockdowns and social distancing orders may have contributed to the rise in suicide attempts, the CDC said. In spring 2020, there was a 16.8% drop in emergency department visits among men and women aged 18 to 24 compared with the same time period a year prior.

By June 2020, 25% of surveyed adults in the same age group reported experiencing suicidal thoughts related to the pandemic in the last 30 days, consistent with 2019. But actual emergency room visits for suicide attempts rose throughout the pandemic, the CDC said.

In adolescent girls, average weekly visits to the emergency department for suspected suicide attempts from February 2021 to March 2021 jumped by 50.6% from the same time period during the prior year.

Emergency department visits for suspected suicide attempts include visits for suicide attempts, as well as some non-suicidal self-harm, according to the CDC.

The data was gathered by the CDC from the National Syndromic Surveillance Program’s emergency department visit data in 49 states. Not all of the states had consistent emergency department visit data and race and ethnicity data were not available at the time of the study.

Suspected suicide attempts are often higher among young girls than young boys, but in this study, the difference was more pronounced than prior studies, due to the pandemic. The study points to an increase in emergency department visits for suspected suicide attempts, not an increase in actual suicides, the CDC emphasized in the study.

The increase in suspected suicide attempts in young people could be attributed to social distancing, including a lack of connection to schools, teachers and friends. Other factors could include barriers to mental health treatment, increase in substance abuse and anxiety about the health and economic state of family at home.

Average emergency department visit rates for mental health concerns and suspected child abuse also increased in 2020 comparted to 2019, potentially contributing to the increase in suspected suicide attempts.

The study notes that increased time at home for kids may have alerted parents to their child’s mental health struggles and led them to seek treatment at emergency departments, potentially contributing to the rise.

The study also noted that the data likely underrepresents the real number of suspected suicide attempts because Americans were hesitant to go to hospitals during the pandemic, in fear of contracting Covid-19.