The Impact of School Closures on Service Utilization in School-Based Health Centers.

BACKGROUND: The pandemic was followed by a severe mental health crisis in youth with both an increase in the prevalence of mental health problems and a decrease in requests for and access to care. METHODS: data were extracted from the school-based health center records in three large public high schools that include under-resourced and immigrant communities. Data from 2018/2019 (pre-pandemic), 2020 during the pandemic, and then in 2021 after the return to in-person school were compared regarding the impact of in-person, telehealth, and hybrid care. RESULTS: Despite the increase in mental health needs globally, there was a dramatic decrease in referrals, evaluations, and the total number of students seen for behavioral health care. The time course of this decrease in care was specifically associated with the transition to telehealth, although treatment did not return to pre-pandemic levels, even after in-person care became available. CONCLUSIONS: Despite ease of access and increased need, these data suggest that telehealth has unique limitations when delivered in school-based health centers.

Recorded infection control messages delay inter-professional communication but are not associated with COVID-19 prevalence or mortality: insights from a national switchboard analysis.

Appropriate dissemination of information to the general public is a key component of the pandemic response. In 2018, recorded infection control advice messages were affixed to 30% of England's automated hospital switchboards during the seasonal influenza and norovirus outbreaks. As the majority of messages were mandatory for all callers, healthcare professionals using the hospital switchboard - including during time-critical emergencies - had their enquiries significantly delayed by these measures. Importantly, published analyses did not demonstrate an association between these messages and patient outcomes. As of May 2020, 85% of NHS trusts made use of infection control messages; on average, these delayed healthcare professionals by 59.4 seconds per call, but had no clear association with patient outcomes from COVID-19. An ongoing national switchboard quality improvement project seeks to establish a gold standard whereby healthcare professionals with urgent enquiries can press 'X' to skip past infection control messages and have their calls triaged immediately.