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Use of Acute Mental Health Care in U.S. Children's Hospitals Before and After Statewide COVID-19 School Closure Orders.
Zima, Bonnie T; Edgcomb, Juliet Beni; Rodean, Jonathan; Cochran, Susan D; Harle, Christopher A; Pathak, Jyotishman; Tseng, Chi-Hong; Bussing, Regina.
  • Zima BT; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Ga
  • Edgcomb JB; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Ga
  • Rodean J; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Ga
  • Cochran SD; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Ga
  • Harle CA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Ga
  • Pathak J; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Ga
  • Tseng CH; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Ga
  • Bussing R; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Ga
Psychiatr Serv ; 73(11): 1202-1209, 2022 11 01.
Article in English | MEDLINE | ID: covidwho-1861753
ABSTRACT

Objective:

This study aimed to examine changes in child emergency department (ED) discharges and hospitalizations for primary general medical (GM) and primary psychiatric disorders; prevalence of psychiatric disorders among acute care encounters; and change in acute mental health (MH) care encounters by disorder type and, within these categories, by child sociodemographic characteristics before and after statewide COVID-19­related school closure orders.

Methods:

This retrospective, cross-sectional cohort study used the Pediatric Health Information System database to assess percent changes in ED discharges and hospitalizations (N=2,658,474 total encounters) among children ages 3­17 years in 44 U.S. children's hospitals in 2020 compared with 2019, by using matched data for 36- and 12-calendar-week intervals.

Results:

Decline in MH ED discharges accounted for about half of the decline in ED discharges and hospitalizations for primary GM disorders (−24.8% vs. −49.1%), and MH hospitalizations declined 3.4 times less (−8.0% vs. −26.8%) in 2020. Suicide attempt or self-injury and depressive disorders accounted for >50% of acute MH care encounters before and after the statewide school closures. The increase in both ED discharges and hospitalizations for suicide attempt or self-injury was 5.1 percentage points (p<0.001). By fall 2020, MH hospitalizations for suicide attempt or self-injury rose by 41.7%, with a 43.8% and 49.2% rise among adolescents and girls, respectively.

Conclusions:

Suicide or self-injury and depressive disorders drove acute MH care encounters in 44 U.S. children's hospitals after COVID-19­related school closures. Research is needed to identify continuing risk indicators (e.g., sociodemographic characteristics, psychiatric disorder types, and social determinants of health) of acute child MH care.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Schools / Communicable Disease Control / Facilities and Services Utilization / COVID-19 / Hospitals, Pediatric / Mental Health Services Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Child / Humans Country/Region as subject: North America Language: English Journal: Psychiatr Serv Journal subject: Psychiatry Year: 2022 Document Type: Article Affiliation country: Appi.ps.202100582

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Schools / Communicable Disease Control / Facilities and Services Utilization / COVID-19 / Hospitals, Pediatric / Mental Health Services Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Child / Humans Country/Region as subject: North America Language: English Journal: Psychiatr Serv Journal subject: Psychiatry Year: 2022 Document Type: Article Affiliation country: Appi.ps.202100582