Mental Health Utilization in Children in the time of COVID-19

  1. Leah Coates
  2. Rebecca Marshall
  3. Kyle Johnson
  4. Byron A. Foster

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Abstract

Background

In early 2020, coronavirus disease 2019 (COVID-19) was declared a public health emergency and a combination of lockdown and social distancing measures were put in place across the globe. Many children, adolescents and adults have experienced adverse mental health effects related to the pandemic and its impact on daily life, although the long-term impact on individuals and health systems is not well understood.

Methods

This cross-sectional study was based on data from 2018-2021 collected via medical records from our hospital. Admissions were transformed into time-series data, and models were generated to analyze changes in admission rates for mental health emergencies in 2020 and 2021 compared to previous years.

Results

Of 1906 inpatient encounters among 1543 unique patients seen by the Child and Adolescent Psychiatry Consultation-Liaison service, there was a decrease in overall admissions beginning in March 2020, coinciding with statewide lock down due to the COVID-19 pandemic. In April 2020, admissions were reduced 36% compared to average admissions from 2018-2019. By 2021, overall admissions were significantly higher than for the previous three years. Similarly, the count of suicide attempts was significantly higher in 2021 compared to previous years. The rate of patients admitted to inpatient facilities upon discharge was significantly higher during the COVID-19 pandemic period.

Conclusion

Admissions for mental health emergencies fluctuated during the period associated with the COVID-19 pandemic across an array of diagnoses. Increases in admissions and severity of mental health emergencies during COVID-19 may reflect a detrimental impact of the pandemic on the mental health of children, as well as unmet needs during this time.

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    SciScore for 10.1101/2021.08.11.21261712: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: This study was approved by our hospital’s institutional review board (IRB); because the dataset was large and the study was retrospective, informed consent was not obtained, and a waiver of consent approved by the IRB.
    Consent: This study was approved by our hospital’s institutional review board (IRB); because the dataset was large and the study was retrospective, informed consent was not obtained, and a waiver of consent approved by the IRB.
    Sex as a biological variableGender was self-reported and categorized as male, female, transgender male, transgender female, or other.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All statistical analyses were performed in R Studio version 1.2.5001 with the following packages: Methods, dplyr, lubridate, tidyr, ggplot2, and tidyverse.
    ggplot2
    suggested: (ggplot2, RRID:SCR_014601)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.08.11.21261712v1 on medRxiv