In an effort to better understand the influence the COVID pandemic had on reasons for psychiatric visits to the Emergency Department, researchers at a New York City hospital compared diagnoses and referral outcomes for children, adolescents and adults in January and February of 2020 (pre COVID) versus March and April of 2020 (after COVID started). Researchers identified a number of interesting patterns, including the following:
- Fewer children and adolescents were seen once COVID began (65) compared to the same length of time prior to COVID (202).
- However, the children and adolescents who were seen were more likely to exhibit psychotic symptoms and were more likely to be transferred to inpatient hospitalization than children and adolescents seen pre-COVID.
- Similarly, adult patients were also more likely to be transferred to inpatient hospitalization during COVID than before COVID.
- During COVID adult patients also reported difficulty obtaining outpatient services than pre-COVID patients.
- Only a third of patients were tested for COVID, but those who tested positive were more likely to present with psychotic symptoms and less likely to present with depressive symptoms than COVID negative patients.
- There was a 43% decline in patients seen in the emergency department during the first two months of COVID (mostly due to reduced child/adolescent patients).
- 25% of ED visits were due to COVID-specific stressors (unemployment, death of a friend/family member, social isolation).
Researchers hypothesize that reduced child/adolescent patients were likely due to the fact that common referral sources (schools, mental health clinics) were closing down at that time, and some school-stressors (bullying) may have been less prevalent, though parent’s fear of contracting COVID was also likely a factor that reduced the number of patients presenting. Vaccination rates are slowly climbing, but it could be months before the majority of physically healthy adults and children have access to a vaccine, therefore some of these patterns could still be affecting ED referrals.
Ferrando, S. J., Klepacz, L., Lynch, S., Shahar, S., Dornbush, R., Smiley, A., … & Bartell, A. (2020). Psychiatric emergencies during the height of the COVID-19 pandemic in the suburban New York City area. Journal of psychiatric research. Iin press)
Maria Stacy, MA
WKPIC Doctoral Intern