Study Finds Mental Health-Related Emergency Department Visits Dropped in 2020, Began Increasing in Mid-2021

Individuals’ mental health was challenged throughout the beginning months of the COVID-19 pandemic. Compared to previous years, researchers found a 25% increase within mental health conditions that included major depression, generalized anxiety disorder, acute stress, post-traumatic stress, and suicidal ideation.

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Published in JAMA Network, researchers found that adolescents also experienced a continued increase in mental health disorders throughout the COVID-19 pandemic that worsened in the decade prior to the lockdown. In previous years, the emergency department (ED) served as the outlet for individuals in a mental health crisis. The researchers conducted a study that assessed the changes in mental health care in EDs for adolescents during the pandemic.

Previous studies found that adolescents’ mental health worsened from 2009 to 2019, during which time a 40% increase of feeling sad or hopeless occurred in high school aged children. The number grew at the start of the pandemic as more than 25% of high school aged children reported worsened emotional and cognitive health. Researchers found that adolescents without previous signs of mental health symptoms reported increased anxiety and depression, as well.

Researchers created a cross-sectional study that analyzed mental health-related ED visits in adolescents versus other age groups during the COVID-19 pandemic. The researchers used data from previous studies that found mental health visits related to suicide in adolescents did not increase following the pandemic, although the proportion of mental health-related visits increased in 2020 for children aged 5 to 17 years.

However, researchers noted that there was a lack of knowledge on mental health-related ED visits from 2020 to 2021. In the current study, the researchers used data from the National Syndromic Surveillance Program (NSSP), provided by the CDC, that helped find the absolute number and proportion total of mental health-related ED visits.

The study noted that for an ED visit to be deemed mental health-related, it needed to include a mental health crisis that was the primary reason for the visit or if a mental health condition was present and diagnosed in the adolescent.

Separated into 3 measures, the researchers noted that the study calculated the total number of ED visits, mental health-related ED visits, and the proportion of ED visits that were mental health-related.

The results from the study showed that adolescent aged 12 to 17 years had the lowest absolute number of mental health-related ED visits, compared to adults 65 years and older, who had the highest. However, at the start of 2020 and into 2021, mental health-related ED visits increased for all age groups.

Within the increase, the researchers found that the oldest cohort had the lowest percentage of visits and adolescents had the highest number of visits per week.

“The adolescent group showed the steepest average increase in the proportion of ED visits that were mental health-related once the pandemic was declared, from just more than 10% (741 mental health-related visits out of 7728 total visits) in the week leading up to the onset of the pandemic in mid-March 2020, to a peak of nearly 15% (319 mental health-related visits out of 2252 total visits) 6 weeks after the pandemic declaration (despite the absolute decrease in both categories). This percentage remained elevated throughout subsequent weeks in 2020 and into 2021 relative to the other age cohorts,” said the study authors.

The results concluded that the number of mental health-related ED visits dropped initially in 2020 and began to increase in the middle of 2021, like previous numbers that were assessed in 2019. The researchers concluded that adolescents were in need of mental health care from ED visits quicker than any other age cohort.

The findings suggest that adolescents with mental health conditions must be monitored, as they have a higher demand for mental health care.

Reference

Adolescent Total and Mental Health–Related Emergency Department Visits During the COVID-19 Pandemic. JAMA Network. News release. October 5, 2023. Accessed October 11, 2023. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2810190.