A consultant paediatrician is calling for the allocation of "massive resources" to deal with the impact of the coronavirus pandemic on children's mental health.
Dr Niamh Lynch from the Bon Secours Hospital in Cork says the impact of COVID-19 has been significant.
She has made more urgent referrals to the psychiatric services for children in the last month than she would normally make in a year.
As a result, she is warning of a "new tsunami" of mental health problems in kids after the pandemic.
Dr Lynch told Newstalk Breakfast with Susan Keogh that the last year has been "very difficult" for young people, both from her perspective as a paediatrician and a mother.
"I think the first lockdown was a bit of a novelty, the weather was lovely, we enjoyed going for walks and doing various things in the sunshine," she said.
"The second lockdown when the children were still in school was difficult but I didn't see the same psychological effects that I'm seeing in lockdown number three where the children are out of school again.
"It really doesn't help that the weather has been so awful and it's been dark and very difficult to get out.
"What I've noticed is that children have become increasingly quiet and withdrawn, almost conforming to that Victorian ideal of children being seen and not heard."
Dr Lynch said she did not have any in-person clinics after Christmas and she was only doing phone consultations, but in February she recommenced her clinics.
"I noticed that the children were very, very quiet, normally a four or five-year-old will stomp into the room, put down the coat, ask you who you are, interrogate you, ask you for sweets and stickers and things like that," she said.
"But they were just glued to their mother or father's sides, just peeping out from behind them.
"If you think about it, a four-year-old child will have spent a quarter of their life in lockdown and so coming out is a complete novelty now.
"Reintroducing them into normality again is going to be quite a challenge and will have to be carefully managed."
Dr Lynch added that it takes people who are "slightly removed" to advocate for young people at the moment given that their usual advocates, their parents, are also struggling with the demands of the pandemic.
"I've made more urgent referrals to the psychiatric services for children in the last month than I would normally make in a year, it's shocking," she said.
"We're going to need massive resources to deal with this new tsunami and this new crisis which will come after the pandemic which will be a mental health one in young people and their services are already under-resourced and underfunded."
'A spectrum of presentations'
Speaking on the same programme, Galway GP and Assistant Medical Director at the Irish College of General Practitioners Dr Brian Osborne said he was seeing "a spectrum of presentations" in children.
This includes a range of physical illnesses, as well as lack of motivation and poor sleep in older children, plus increased rates of anxiety and eating disorders.
"The volume of consultations related to mental health presentations has really increased in the last number of months, I've never seen anything like it and it is deeply concerning," Dr Osborne said.
He also echoed Dr Lynch's comments that very little has been heard from children in general during the pandemic.
It follows similar sentiments expressed by Dr Deirdre McGillicuddy, a primary school teacher and Assistant Professor in Education at UCD, who said children have been "very silent and voiceless" throughout the crisis.
The current situation is a "completely abnormal state" for children and their families to be in, he said, which while difficult for everyone in society, is "particularly" hard on children.
There is increased anxiety in the home at the moment, which kids take in, leading to their higher levels of anxiety too, Dr Osborne explained.
He added that the presentations he is seeing are worse in young people who are already socially disadvantaged, some of whom are being "completely isolated" from their education and peers.
