Acute Care for Mental Health Conditions Rose Notably Among Adolescent Females During Pandemic
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Jim Liebelt Jim Liebelt's Blog - Published Jul 13, 2023
The following is excerpted from an online article posted by JAMA Psychiatry.
Before the COVID-19 pandemic, youth emergency department (ED) use for mental health problems was increasing, and boarding (waiting in an ED or medical inpatient unit) before inpatient psychiatric care was common. The pandemic exacerbated stressors among youth, including social isolation, school disruptions, and parental unemployment, and rates of depression and anxiety have doubled since the start of the pandemic. In 2021, 20% of high school students seriously considered suicide, and 9% attempted suicide.
This retrospective, cross-sectional study used deidentified health insurance claims data from March 2019 to February 2022 for members of commercial health plans spanning all 50 states (OptumLabs Data Warehouse). It included youth aged 5 to 17 years enrolled in both medical and behavioral health coverage in a given month.
The study's sample included 4.1 million youth was 51% male, and 41% were aged 13 to 17 years, and identified 88 665 youth mental health ED visits. Compared with the baseline year, the fraction of youth with at least 1 mental health ED visit decreased 17.3% in pandemic year 1 but increased 6.7% in year 2.
Changes in the fraction of youth having a mental health ED visit from baseline to pandemic year 2 varied by age and sex: the fraction of females aged 13 to 17 years with visits increased 22.1%, the fraction for males aged 5 to 12 decreased 15.0%, and the fraction for males aged 13 to 17 years decreased 9.0%.
The percent of mental health ED visits that resulted in an inpatient psychiatry admission was 20.9% in the baseline year and increased 13.1% from baseline to pandemic year 1 and 8.4% from baseline to pandemic year 2.
In the context of a national emergency in children’s mental health, we observe a 7% increase in the fraction of youth with any mental health ED visits from baseline to pandemic year 2. Among adolescent females, there was a notable 22% increase. Into pandemic year 2, the percentage of mental health ED visits that resulted in a psychiatric admission increased by 8%, and there was a striking 76% increase in prolonged boarding.
