Youth aged 5 to 17 were more likely to present to an emergency department (ED) for suicidal thoughts and behaviors in the second half of 2020 compared with the same period in 2019, a study in JAMA Psychiatry has found.
Specifically, suicide-related ED visits among female youth from June 1 to December 15, 2020, were significantly higher than in the corresponding months in 2019. Youth with no history of outpatient mental health or suicide visits and those with comorbid psychiatric conditions documented at the ED visit also had a higher risk of presenting with suicide-related problems from September to December 2020 compared with the same period in 2019.
“As suicide-related encounters have made up more ED volume during the pandemic, increasing ED-based interventions, staff trained in addressing emergency mental health needs, and aftercare resources may also be valuable in addressing the needs of this population,” wrote Kathryn K. Ridout, M.D., Ph.D., of The Kaiser Permanente Medical Group and colleagues.
Ridout and colleagues analyzed electronic health record data for patients aged 5 to 17 years seeking emergency care for suicidal thoughts or behaviors at Kaiser Permanente Northern California from January 1, 2020, to December 15, 2020, and for the same dates in 2019. The researchers focused on four time frames: pre–COVID-19 pandemic period (January 1 to March 9), the period during which shelter-in-place orders were in effect in the Bay Area and California (March 10 to May 31), the summer (June 1 to August 31), and the fall (September 1 to December 15).
There were 2,123 youth with suicide-related ED encounters in 2020 compared with 2,339 in 2019. The following patterns were found:
- The incidence rates of suicide-related ED encounters were significantly lower in March through May 2020 compared with this period in 2019—likely because of shelter-in-place orders at the beginning of the pandemic—before returning to prepandemic levels in June through December 2020.
- Female youth had an 11.4% higher risk of presenting with suicidal thoughts or behaviors during the fall compared with the same period in 2019, while male youth had a 21.3% lower risk of presenting with suicidal thoughts or behaviors during this period.
- Relative to all youth ED encounters, youth with no history of outpatient mental health encounters during the previous two years had a 129.4% higher risk of a suicide-related ED encounter during the fall of 2020 compared with fall of 2019.
- There was a 6.7% higher risk of having a comorbid psychiatric nonsubstance diagnosis at the time of the suicide-related ED encounter during the fall of 2020 compared with 2019.
“Preventive efforts, including mental health screening, psychoeducation, and support in connecting to care, may be particularly valuable for these youth and their families,” the researchers wrote. “Innovative and immediately accessible tools for mental health care, such as technology-based care, may address the needs of this population as well.”
For related information, see the Psychiatric Services article “Universal Suicide Risk Screening for Youth in the Emergency Department: A Systematic Review.”
(Image: iStock/MJFelt)
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