Calls to suicide hot lines are surging amid the strain of a drawn-out pandemic, according to the mental health nonprofit NAMI of Cape Cod and the Islands.

“It’s hard to have enough trained volunteers to answer the phone, because there’s so many calls coming in from so many people in need,” said Lisa Belcastro, NAMI’s Martha’s Vineyard coordinator.

The problem exists nationwide, Ms. Belcastro said, but is particularly acute on the Cape and Islands, where according to NAMI the suicide rate is more than twice the state average, and suicide is now the second leading cause of death among people aged 14 to 25.

Statistics from the Martha’s Vineyard Hospital were not available, but Ms. Belcastro said there were 21 suicides on the Cape and Islands between New Year’s Day and early August of this year.

That total does not include fatal overdoses that may have been intentional, she said.

“There are a number of overdoses and alcohol related calls [to emergency services] where no one can tell you for certain whether the person was attempting suicide or accidentally overdosed,” Ms. Belcastro said.

The Covid-19 pandemic has ratcheted up existing anxieties and fears, particularly among teens and even younger children, said veteran mental health counselor David Araujo, former director of the Island Intervention Center at Martha’s Vineyard Community Services.

“It’s kind of like throwing a pebble into something that’s already [overloaded],” said Mr. Araujo, who now practices at the hospital.

He said much of the overload comes from social media, which has been pressurizing adolescent insecurities since long before the pandemic.

“Shaming, bullying and things of that nature that go on . . . stress kids a lot more,” Mr. Araujo said. “Covid is just kind of the icing on the cake.”

Transgender children, in particular, are more vulnerable to thoughts of suicide, Mr. Araujo said.

“My son, who is now a freshman, has been talking about kids having gender identity issues since fourth grade — at that age group, kids are already struggling,” he said.

Suicide awareness and prevention has been front and center on the Vineyard this fall, with the fourth annual Darkness Into Light walk held last month at Bend in the Road Beach in Edgartown.

Mr. Araujo said the risk of suicide is also higher among homeless Islanders.

“We have a pretty significant homeless population,” he said. “If you’re homeless and you don’t have a job and you feel overwhelmed . . . [you are] struggling on a constant basis with life, and is it worth living.”

Meanwhile, the need for counseling services has swamped the Vineyard’s mental health professionals, making it harder for many Islanders to find the treatment they need, Ms. Belcastro said.

“We have some amazing therapists and counselors here on the Island, and they’re inundated,” she said. “Everyone is so overbooked.”

At the Martha’s Vineyard Regional High School, a new training program will equip teens themselves with basic peer-support skills so they can immediately help friends at risk get professional care that could be life-saving.

Called Mental Health First Aid, it teaches trainees to recognize the signs and symptoms of a crisis, said longtime high school guidance counselor Amy Lilavois. “It’s like CPR for mental health,” Ms. Lilavois said of the program.

Teachers and other adults across the Island school system have taken the training, which is available in customized versions for teens, adults, seniors and other groups, she said.

Starting next month, as part of the high school’s required, year-long PE/health curriculum, Ms. Lilavois and fellow counselor Matt Malowski will teach six class-length sessions in Mental Health First Aid to the entire sophomore class — about 170 students, Ms. Lilavois said, if none are opted out by their parents.

“It’s pretty in-depth,” Ms. Lilavois said. “Matt and I are both licensed mental health counselors, and [for] anybody who wants to talk with us afterward, we’re available. This is all in the hope of preventing any more suicides with our age group.”

This year’s instruction is a pilot program, Ms. Lilavois said, with the goal of educating each year’s tenth-graders.

“Within three years, three-fourths of our students will be trained in mental health literacy,” she said.

While peer support, early intervention and referrals to professional services can go a long way in preventing suicides, students who are in immediate crisis receive more urgent care.

“We have been . . . working closely with the hospital and Martha’s Vineyard Community Services to tighten up our crisis communications,” Ms. Lilavois said. “There’s a seamless flow, when a student is in a crisis, that they get the help they need right away.”

But when someone is in urgent need of hospitalization or transfer to an off-Island mental health facility, it can be hard to find a bed, said Dr. Karen Casper, head of the emergency department at Martha’s Vineyard Hospital.

“Covid has really reduced the availability of beds [and] other services,” Dr. Casper said. Mental health workers are also in shorter supply, and wait times in the emergency room are longer, she added.

“It’s not just us having these troubles,” said Dr. Casper, who regularly confers with other emergency room managers in the Mass General Brigham network. “Since Covid, the strain on the system — at so many levels — exists, and it has really impacted people coming to us with mental health issues,” she said.

Even without special training in mental health first aid, friends and family members can help identify someone at risk of suicide. Mr. Araujo listed several key signs:

“Does the individual have a method? Does the individual have intent? Does the individual have a plan? Does the individual have access to guns?” he said. “When people are starting to feel this way, when they start having these thoughts, the hair on the back of my neck does rise up,” he added.

The hospital emergency department is prepared to respond, Dr. Casper said. A full-time psychiatrist joined the staff before the pandemic, and emergency room staff are trained to screen patients for suicidal thoughts and substance abuse disorders.

“It’s important that people realize that behavioral health is part of health care,” she said.

The national suicide prevention hot line is 1-800-273-8255, with the veterans hot line at extension 1.