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Abstract
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OBJECTIVE: To describe changes in ED psychiatric visits during the pandemic in both rural and non-rural regions in the US.
PATIENTS AND METHODS: This cohort study was performed across 22 EDs in the Midwest and Southern United States from January 01, 2019 to April 22, 2021. Prevalence of psychiatric visits were compared before and after the COVID-19 pandemic, defined as starting on March 01, 2020. Psychiatric and nonpsychiatric visits were defined based on primary clinician-assigned diagnosis. The primary endpoint was average daily visits normalized to the average daily visit count prior to the pandemic, labeled as relative mean daily visits (RMDV).
RESULTS: Psychiatric visits decreased by 9% (RMDV: 0.91, 95% CI: 0.89-0.93) during the pandemic period, while nonpsychiatric visits decreased by 17% (RMDV: 0.83, 95% CI: 0.81-0.84). Black patients were the only demographic group with a significant increase in psychiatric visits during the pandemic (RMDV: 1.12, 95% CI: 1.04-1.19). Periods of outbreaks of psychiatric emergencies were identified in most demographic groups including among male and pediatric patients. However, outbreaks detected among Black patients were sustained the longest at 6 months. Unlike older adults who experienced outbreaks in the spring and fall of 2020, outbreaks among pediatric patients were detected later in 2021.
CONCLUSION: In this multisite study, total ED visits declined during the pandemic, but psychiatric visits declined less than non-psychiatric visits. Black patients suffered a greater increase in psychiatric emergencies compared to other demographic groups. There is also concern for increasing outbreaks of pediatric psychiatric visits as the pandemic progresses.
Language: en |