Of the more than 110,000 asylum seekers who have recently landed in New York City, 20,000 are children now enrolled in public schools, facing challenges both familiar to any kid who has moved away and towering in their emotional complexity. The most recent arrivals have been met by Mayor Eric Adams’s downcast mood and language of resignation, his well-documented, inflammatory claims that the migrant situation will “destroy” New York and that “the city we knew, we’re about to lose.” There is little to suggest that the school system is prepared for the mental health crisis that looms.

The pandemic continues to reverberate. The city was already struggling to meet the needs of families whose children have suffered as a function of both learning loss and mounting incidents of anxiety and depression. More than 8,600 children in the city lost a parent to Covid. Over the course of 2021, according to data from the Department of Health, 9 percent of high school students reported that they had attempted suicide.

In response to these and other troubling statistics, the Adams administration released a mental health plan last March with a focus on children and teenagers and the goal of expanding clinical services in schools. But that effort was likely to be hampered by the critical labor shortage in the counseling fields. A RAND report commissioned by the city and released last year found that there were very few psychologists and social workers available to patients who could not pay out of pocket, to say nothing of those who spoke a language other than English. The shortage, in essence, has been most acutely felt in the places where the need is greatest.

The migrant crisis has been imagined largely in terms of the housing emergencies that have flowed from it. But it is also a psychological crisis unfolding within the context of a pre-existing one. “We are seeing the highest level of mental health need we have ever seen, in our city, in our clinic, in our country,” Alan Shapiro told me recently.

Dr. Shapiro is the co-founder and executive director of Terra Firma, a 10-year-old health care clinic in the Bronx that specializes in helping immigrant children and their parents. The arrival of migrants on such a grand scale has made it clear how essential this kind of comprehensive care is — care that extends beyond immunizing migrant children in shelters to prepare them for school and tending to their physical well-being.

About 80 percent of families the clinic is seeing now are migrants from Venezuela, where crime, unrest and deprivation have been the worst in the country’s history. “There has been so much suffering before the families even leave,” Dr. Shapiro said. Often they have spent time temporarily living in other countries also afflicted with instability. A Venezuelan family might have passed through Ecuador, which has been in the midst of its own political unraveling. Traveling through the Darién Gap, the dangerous terrain connecting the North and South American continents within Central America, is intensely traumatic when it isn’t fatal.

Reaching the destination is a precarious kind of relief; the children carry with them here the atrocities they have witnessed along the way. One of the most upsetting cases he has seen, Dr. Shapiro told me, was a family whose children were kidnapped in Mexico. The parents had to come up with $3,000 to get them back. They eventually landed in New York. “Before, they were just on the run, but once they had the stability of being in a shelter, they broke down,” Dr. Shapiro told me. The children especially were undone.

“If you have a depressed or anxious parent, how can they themselves be that buffering caregiver?” Dr. Shapiro asked. “Parents have to feel that they are getting the support they need so their own stress level goes down. That is the monumental task we have in this country for all indigent people, and now for migrants as well.”

In New York, the bleak state of treatment availability has forced primary care doctors and teachers deeper into roles as counselors. “Ten years ago we were dealing with asthma and failure to thrive, but now we have to focus on mental health, and the training of doctors has to catch up to that need,” Dr. Shapiro said. “We are not there yet.”

For the most part, the mental health needs of migrant children are going to be addressed in schools, Laura Guy, program and outreach coordinator at Fordham University’s Clinical Mental Health Services, told me. This is because getting children’s mental health services in New York is, as she pointed out, incredibly complicated no matter who you are, and a migrant family may be entirely unfamiliar with it. How much can be done within that infrastructure, with the social workers and mindfulness programs on hand, is hardly clear.

Jenna Lyle, a spokeswoman for the Department of Education, said that the department was “continuing to work to ensure every new student entering our system has what they need and that our schools are well equipped to support the whole child.”

One of the many hurdles, Ms. Guy said, is that children of asylum-seeking families are typically placed in schools where there is space, not necessarily in those that have the particular resources that could benefit them. Last spring, a school in Lower Manhattan found itself with six migrant children from Latin America but no Spanish speakers to accommodate them. The school contacted Clinical Mental Health Services, which generally focuses its work in the Bronx. It deployed two Colombian graduate students to administer cognitive behavioral therapy meant to help with integration. At the baseline, the new students, who were between 11 and 14 years old, struggled with the anxiety of taking classes in a language they did not understand and adapting to life in a city if they had not come from one.

This week, Mayor Adams proposed budget cuts of 15 percent across city agencies, citing the burdens of the migrant influx. The Fiscal Policy Institute, an independent think tank, quickly responded with its own arithmetic, arguing that while the strains were obvious, the proposed $10 billion in cuts were much higher than increased cost estimates. If anything is to bring us back to “the city we knew,” it would seem to be the deepest possible investment in so many distraught children building their lives here.