Update: COVID-19 Pandemic–Associated Changes in Emergency Department Visits — United States, December 2020–January 2021

Adjemian, Jennifer; Hartnett, Kathleen P.; Kite-Powell, Aaron; DeVies, Jourdan; Azondékon, Roseric; Radhakrishnan, Lakshmi; Santen, Katharina L. van; Rodgers, Loren

doi:10.15585/mmwr.mm7015a3

Cited by 91 publications

(103 citation statements)

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“…Consistent with existing literature, our study showed an initial decrease in the number of mental health–related ED visits at the onset of the pandemic followed by a significant increase in the proportion of mental health–related ED visits out of all adolescent ED visits starting in July 2020 [ [11] , [12] , [13] , [14] ]. The frequency of ED visits related to eating disorders increased markedly during the year 2020, though we did not see such an increase in other mental health diagnoses, such as substance use and other mental health conditions (which included depression and anxiety), a finding that has also been reported in the United States [ 13 , 14 ]. As for hospitalization rates within diagnostic categories, no significant change was noted.…”

Section: Discussionsupporting

confidence: 90%

“…[11][12][13][14] The frequency of ED visits related to eating disorders increased markedly during the year 2020, though we did not see such an increase in other mental health diagnoses, such as substance use and other mental health conditions (which included J o u r n a l P r e -p r o o f depression and anxiety), a finding that has also been reported in the US. 13,14 As for hospitalization rates within diagnostic categories, no significant change was noted.…”

Section: Discussionsupporting

confidence: 54%

“…eating disorders, suicidality) but not all types of mental health visits. 13,14 In this report, we compare the frequency of mental health-related ED visits and hospitalization rates in adolescents pre-and post-onset of COVID-19.…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

“…Similarly, a retrospective study from 10 European countries found a significant decrease in the number of psychiatric emergency visits between March and April 2020 versus 2019 with a smaller proportion of youths admitted to an observation unit [ 10 ]. However, a small number of studies analyzing ED visits across the United States during the year 2020 showed a significant increase in the proportion of mental health–related visits among all adolescent visits in the second half of 2020 [ 11 , 12 ], with some studies reporting increases in the proportion of some (i.e., eating disorders, suicidality) but not all types of mental health visits [ 13 , 14 ]. In this report, we compare the frequency of mental health–related ED visits and hospitalization rates in adolescents before and after onset of COVID-19.…”

mentioning

confidence: 99%

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Mental Health–Related Emergency Department Visits in Adolescents Before and During the COVID-19 Pandemic: A Multicentric Retrospective Study

Chadi

Piano

Osmanlliu

et al. 2021

Journal of Adolescent Health

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Purpose The purpose of this study was to compare pre/post-COVID-19 changes in mental health–related emergency department visits among adolescents. Methods We conducted a retrospective analysis of all mental health–related emergency department visits in two large tertiary pediatric hospital centers between January 2018 and December 2020. We described monthly pre/post-COVID-19 changes in frequency and proportion of mental health visits as well as changes in hospitalization rates for eating disorders, suicidality, substance use, and other mental health conditions. Results We found an increase in the proportion of mental health–related emergency department visits during the months of July–December 2020 ( p < .01). There was a 62% increase in eating disorder visits between 2018–2019 and 2020 ( p < .01). No pre pandemic/postpandemic changes were found in the proportion of visits resulting in hospitalization for any of the four diagnostic categories. Conclusions Our study suggests significant impacts of COVID-19 on adolescent mental health and a need for further longitudinal research work in this area.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 54%

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

mentioning

confidence: 99%

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Mental Health–Related Emergency Department Visits in Adolescents Before and During the COVID-19 Pandemic: A Multicentric Retrospective Study

Chadi

Piano

Osmanlliu

et al. 2021

Journal of Adolescent Health

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“…Second, full toxicology results for nonfatal overdoses were not available, and opioid and benzodiazepine involvement in nonfatal overdoses is likely underestimated because comprehensive toxicology testing of persons treated for overdoses varies within and across EDs, and hospital discharge codes with drug specific information might be unavailable ( 8 ). Third, despite only including consistently reporting facilities, ED visits decreased sharply after implementation of COVID-19 mitigation measures in March 2020, which might inflate rate increases ( 9 ). Fourth, four states (Illinois, Missouri, Pennsylvania, and Wisconsin) reported overdose deaths from varying subsets of counties.…”

Section: Discussionmentioning

confidence: 99%

Trends in Nonfatal and Fatal Overdoses Involving Benzodiazepines — 38 States and the District of Columbia, 2019–2020

Liu¹,

O’Donnell²,

Gladden³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

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National Trends in Mental Health–Related Emergency Department Visits Among Youth, 2011-2020

Bommersbach

McKean

Olfson

et al. 2023

JAMA

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ImportanceThere has been increasing concern about the burden of mental health problems among youth, especially since the COVID-19 pandemic. Trends in mental health–related emergency department (ED) visits are an important indicator of unmet outpatient mental health needs.ObjectiveTo estimate annual trends in mental health–related ED visits among US children, adolescents, and young adults between 2011 and 2020.Design, Setting, and ParticipantsData from 2011 to 2020 in the National Hospital Ambulatory Medical Care Survey, an annual cross-sectional national probability sample survey of EDs, was used to examine mental health–related visits for youths aged 6 to 24 years (unweighted = 49 515).Main Outcomes and MeasuresMental health–related ED visits included visits associated with psychiatric or substance use disorders and were identified by International Classification of Diseases-Ninth Revision, Clinical Modification (ICD-9-CM; 2011-2015) and ICD-10-CM (2016-2020) discharge diagnosis codes or by reason-for-visit (RFV) codes. We estimated the annual proportion of mental health–related pediatric ED visits from 2011 to 2020. Subgroup analyses were performed by demographics and broad psychiatric diagnoses. Multivariable-adjusted logistic regression analyses estimated factors independently associated with mental health–related ED visits controlling for period effects.ResultsFrom 2011 to 2020, the weighted number of pediatric mental health–related visits increased from 4.8 million (7.7% of all pediatric ED visits) to 7.5 million (13.1% of all ED visits) with an average annual percent change of 8.0% (95% CI, 6.1%-10.1%; P &lt; .001). Significant linearly increasing trends were seen among children, adolescents, and young adults, with the greatest increase among adolescents and across sex and race and ethnicity. While all types of mental health–related visits significantly increased, suicide-related visits demonstrated the greatest increase from 0.9% to 4.2% of all pediatric ED visits (average annual percent change, 23.1% [95% CI, 19.0%-27.5%]; P &lt; .001).Conclusions and RelevanceOver the last 10 years, the proportion of pediatric ED visits for mental health reasons has approximately doubled, including a 5-fold increase in suicide-related visits. These findings underscore an urgent need to improve crisis and emergency mental health service capacity for young people, especially for children experiencing suicidal symptoms.

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Update: COVID-19 Pandemic–Associated Changes in Emergency Department Visits — United States, December 2020–January 2021

Cited by 91 publications

References 3 publications

Mental Health–Related Emergency Department Visits in Adolescents Before and During the COVID-19 Pandemic: A Multicentric Retrospective Study

Mental Health–Related Emergency Department Visits in Adolescents Before and During the COVID-19 Pandemic: A Multicentric Retrospective Study

Trends in Nonfatal and Fatal Overdoses Involving Benzodiazepines — 38 States and the District of Columbia, 2019–2020

National Trends in Mental Health–Related Emergency Department Visits Among Youth, 2011-2020

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