The aftermath of the COVID-19 pandemic on pediatric mental health: A pediatric emergency department's perspective.

BACKGROUND: Pediatric mental health visits in the United States has become a public health crisis. Pediatric emergency departments (PED) encounter these patients during mental health emergencies. The COVID-19 pandemic disrupted the social environment of pediatric patients which potentially lead to new and worsening mental health issues. This study examined the proportion of mental health visits to PED around the first wave of the COVID-19 pandemic. METHODS: This retrospective cohort study assessed the proportion of mental health visits at a urban, PED between September 2019 to February 2022. Inclusion criteria were subjects aged 6 to 18 years with a holding order assigned, and one of identified mental health International Classification of Disease, Tenth Division (ICD-10) codes: F01-F99, T14.19, R45, R46.89. Proportion of mental health visits were compared in 6-month periods with the first 6-months representing the pre-COVID-19 period. Secondary analysis compared demographic information and ICD-10 codes. RESULTS: A total of 1036 charts were studied: 126 charts from 2019 to 2020, 512 from 2020 to 2021, and 398 from 2021 to 2022. The proportion of mental health visits from September 2019 to February 2020 was 1.4%, and for the following 6-month periods, the proportion of mental health visits was 1.2%, 7.5%, 4.9%, and 5.7%. There was a statistically significant difference (p < 0.001) demonstrating a higher proportion of mental health visits after the start of the COVID-19 pandemic. Secondary analysis demonstrated statistically significant difference in both median age (p < 0.001) and median length of hospitalization (p < 0.001). CONCLUSION: This study demonstrated a significant increase in pediatric mental health visits following the start of the COVID-19 pandemic. We believe further investigation into the needs and management during acute surges will improve the care we provide to this vulnerable population.

Resolution of Concussion Symptoms After Osteopathic Manipulative Treatment: A Case Report.

A concussion is the result of a biomechanical force directed toward the head, causing neurologic dysfunction. The inflammatory response and the production of reactive oxygen species are proposed mechanisms for the symptoms and long-term sequelae of concussion. Osteopathic manipulative treatment (OMT) may help reduce inflammation by improving glymphatic flow. The authors describe the effect of OMT on a patient with mild concussion symptoms, including nausea, dizziness, tinnitus, and imbalance. The patient was evaluated with the Sensory Organization Test before and after undergoing a 25-minute session of OMT. After the session, the patient reported resolution of symptoms, and his sensory organization test score improved by 6 points. The role of OMT must be further investigated as an essential and cost-effective tool in the management of concussions.