Friday, February 5, 2021

Pandemic Prompts Increase in Emergency Department Visits for Mental Illness, Suicide, Overdose

Emergency department (ED) visits for mental health conditions, suicide attempts, and drug overdoses were higher in mid-March through October 2020, during the COVID-19 pandemic, compared with the same period in 2019, a study in JAMA Psychiatry has found. These increases ran counter to an overall decline in ED visits for all causes that began soon after the nation implemented COVID-19 mitigation measures in mid-March 2020.

Kristin M. Holland, Ph.D., M.P.H., of the National Center for Injury Prevention and Control and colleagues analyzed data from the Centers for Disease Control and Prevention’s National Syndromic Surveillance Program to examine national changes in ED visits for mental health conditions, suicide attempts, drug overdose, opioid overdose, intimate partner violence, and suspected child abuse and neglect from December 30, 2018, to October 10, 2020. The program captures roughly 70% of ED visits from more than 3,500 EDs in 48 states and the District of Columbia.

When the researchers compared median weekly ED visit counts between March 15 and October 2020 with the same period in 2019, they found the following increases per 100,000 visits:

  • Visits for mental health conditions rose from 40,257 to 42,610.
  • Visits for suicide attempts rose from 4,656 to 4,940.
  • Visits for all drug overdoses rose from 13,371 to 15,604.
  • Visits for opioid overdoses rose from 4,168 to 5,502.

“[T]he findings suggest that visits for these outcomes were likely of sufficient severity that treatment at an ED was a necessary risk during the pandemic, despite stay-at-home orders advising people to avoid public spaces,” Holland and colleagues wrote. They added that the visits for all drug and opioid overdoses were especially compelling.

“This finding might reflect changes in the illicit drug supply during the pandemic and that persons using opioids used them alone or in higher-risk ways, increasing the likelihood of [overdose], or that they lacked access to naloxone or other risk-reduction services—all potential effects of COVID-19 mitigation measures,” they continued.

The researchers noted that their results likely underestimate the number of visits associated with these measures because many patients who experience mental health conditions, suicide attempts, and overdoses do not visit an ED.

“These findings suggest that ED use and priorities for care seeking shifted during the COVID-19 pandemic, underscoring mental health, substance use, and violence risk screening and prevention needs during public health crises,” they wrote.

For related information, see the Psychiatric News article “Expect a ‘Long Trail’ of Mental Health Effects From COVID-19.”

(Image: iStock/Jobalou)

APA’s Town Hall on How Racism Impacts Workforce Diversity Is Next Monday

Register now for the town hall “Structural Racism & Psychiatric Residency Training: Recruitment, Retention, and Development,” to be held Monday, February 8, at 8 p.m. ET. Panelists will address the disproportionate number of minority psychiatrists, their experiences in different practice settings, and why having diversity in the psychiatric workforce psychiatry is important for everyone.


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