The Impact of the COVID-19 Pandemic on Psychiatric Emergency Service Volume and Hospital Admissions

Abstract

Background During the COVID-19 pandemic, there have been an increasing number of emergency department (ED) visits for behavioral health reasons, even as overall ED volumes have decreased. The impact of the pandemic and related public health interventions on specialized psychiatric emergency services has not been described. These services provide high intensity care for severely ill patients who are likely to be homeless and underserved. Objective We describe the change in total volume and psychiatric hospitalization rates among three psychiatric emergency services across the United States. Methods Change in volumes and hospitalization were assessed for statistical significance using a seasonal autoregressive integrated moving average with exogenous factors model from January 2018 to December 2020. Results The pandemic’s impact on volumes and hospitalization varied by site. In Denver (CO), there was a statistically significant 9% decrease in overall volumes, although an 18% increase in hospitalizations was not significant. In New York City (NY), there was a significant 7% decrease in volumes as well as a significant 6% decrease in hospitalizations. In Portland (OR), volumes decreased by 4% and hospitalizations increased by 6% although differences did not reach statistical significance. Conclusion There has been a decrease in volume at these service after the pandemic, but there are substantial variations in the magnitude of change and demand for hospitalization by region. These findings suggest a need to understand where patients in crisis are seeking care and how systems of care must adapt to changing utilization in the pandemic era.

Psychiatric Emergencies in Los Angeles County During, and After, Initial COVID-19 Societal Restrictions: An Interrupted Time-Series Analysis

“…Counter to expectations, however, in the US and elsewhere, visits for emergency psychiatric care fell in spring 2020 (Holland et al, 2021 ). In addition, a report on three specialty psychiatric emergency centers in the US finds an 8 to 9 percent drop in psychiatric emergencies after March 15, 2020 (Simpson et al, 2021 ). This decline coheres with the broader observation nationwide of avoidance of health care visits unrelated to COVID-19.…”

Access to Mental Health Care during the First Wave of the COVID-19 Pandemic in Italy: Results from the COMET Multicentric Study

“…A few studies have assessed the use of mental health resources, especially during the first wave of the pandemic. Most evidence relies on qualitative reports from populations of service users or from data coming from limited settings, i.e., emergency departments [ 45 , 46 , 47 , 48 ]. An in-depth description of the use of mental health services during the COVID-19 pandemic is necessary in order to delineate new pathways to care and to develop supportive interventions for the general population [ 11 , 49 ].…”

COVID-19 and Youth Psychopathological Distress in Umbria, Central Italy: A 2-Year Observational Study in a Real-World Setting

“…Indeed, previous studies highlighted that the number of admissions to psychiatric care facilities showed trends similar to the pre-COVID-19 outbreak period ( 39 ). This result could be due to an adaptation of mental services to give help during the pandemic, especially implementing digital mental health services ( 40 ), while it is in contrast with other findings, e.g., those concerning the decrease of new accesses to psychiatric emergency units ( 41 – 43 ). Based on the stated above, access to care during the COVID-19 emergency should be further investigated since it represents a complex issue that relies on several possible determinants ( 44 ).…”