ABSTRACT
Introduction: The COVID-19 pandemic has affected mental health globally, but the impact on referrals and admissions to mental health services remains understudied. Objective(s): To assess patterns in psychiatric admissions, referrals, and suicidal behavior before and during the COVID-19 pandemic in Denmark. Method(s): Utilizing hospital and Emergency Medical Services (EMS) health records covering 46% of the Danish population, we compared psychiatric in-patients, referrals to mental health services and suicidal behavior in years prior to the COVID-19 pandemic to levels during the first lockdown (March 11 - May 17, 2020), inter-lockdown period (May 18 - December 15, 2020), and second lockdown (December 16, 2020 - February 28, 2021) using negative binomial models. Result(s): The rate of psychiatric in-patients declined compared to pre-pandemic levels (RR = 0.95, 95% CI = 0.94 - 0.96, p < 0.01). Referrals were not significantly different (RR = 1.01, 95% CI = 0.92 - 1.10, p=0.91) during the pandemic;neither was suicidal behavior among hospital contacts (RR =1.04, 95% CI= 0.94 - 1.14, p=0.48) nor EMS contacts (RR=1.08, 95% CI=1.00 - 1.18, p=0.06). In the age group <18, an increase in the rate of psychiatric in-patients (RR = 1.11, 95% CI = 1.07 - 1.15, p < 0.01) was observed during the pandemic;however, this did not exceed the pre-pandemic, upwards trend in psychiatric hospitalizations in the age group <18 (p=0.78). Conclusion(s): The pandemic was associated with a decrease in psychiatric hospitalizations. No significant change was observed in referrals and suicidal behavior.