Rise in severe psychiatric cases among children during the pandemic

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A new study found that during the pandemic pediatric emergency departments (EDs) saw more children and adolescents who needed a psychiatric admission, as well as an increase in severe conditions, such as bipolar disorder, schizophrenia and substance use disorders. The higher demand for a psychiatric inpatient bed often exceeded availability, resulting in over 12-hour stays in the ED awaiting admission for nearly 20 percent of children with mental health emergencies in 2022, up from 7 percent before the pandemic. Findings were published in Academic Emergency Medicine.

Our data shows that pediatric emergency departments saw more severe mental health presentations during the pandemic, even while the actual number of visits decreased in 2022. The dramatic increase in prolonged ED stays attests to the strain on the system and difficulties finding appropriate psychiatric care for children, whether in the hospital or in the community."

Jennifer Hoffmann, MD, MS, lead author, emergency medicine physician at Ann & Robert H. Lurie Children's Hospital of Chicago and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine

Dr. Hoffmann and colleagues retrospectively studied mental health ED visits by children aged 5 to less than 18 years at nine U.S. hospitals participating in the Pediatric Emergency Care Applied Research Network Registry from 2017 to 2022. They described these visits by period – pre-pandemic (January 2017-February 2020), early pandemic (March 2020-December 2020), mid pandemic (2021) and late pandemic (2022).

In addition to the increased severity of mental health emergencies, they found that during the mid and late pandemic, mental health ED visits increased beyond expected rates among girls, but not among boys.

"We observed a unique vulnerability for girls during the pandemic, which indicates that girls' mental health requires more attention," said Dr. Hoffmann, who also is the Children's Research Fund Junior Board Research Scholar at Lurie Children's.

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