Evaluation of emergency department visits for mental health complaints during the COVID‐19 pandemic

• Published in: Journal of the American College of Emergency Physicians Open 2022-06, Vol.3 (3), p.e12728-n/a
• Main Authors: Sacco, Dana L., Probst, Marc A., Schultebraucks, Katharina, Greene, M. Claire, Chang, Bernard P.
• Format: Article
• Language: English
• Subjects: Anxiety; Coronaviruses; COVID-19; COVID‐19 pandemic; depression; Electronic health records; emergency department visits; Emergency medical care; General Medicine; Hospitals; Mental depression; Mental health; mental health complaints; Original Research; Pandemics; Patients; Physicians; suicidal ideation
• ISSN: 2688-1152; 2688-1152
• DOI: 10.1002/emp2.12728

Background The COVID‐19 pandemic has resulted in over 6 million deaths worldwide as of March 2022. Adverse psychological effects on patients and the general public linked to the pandemic have been well documented. Methods We conducted a retrospective analysis of adult emergency department (ED) encounters with diagnoses of anxiety, depression, and suicidal ideation using International Classification of Diseases, Tenth Revision (ICD‐10) codes at a tertiary care hospital in New York City from March 15 through July 31, 2020 and compared it with ED encounters during the same time period in the previous 3 years (2017–2019). The relative risk (RR) of these diagnoses was calculated comparing a prepandemic sample to a pandemic sample, accounting for total volume of ED visits. Results A total of 2816 patient encounters met the inclusion criteria. The study period in 2020 had 31.5% lower overall ED volume seen during the same time period in the previous 3 years (27,874 vs average 40,716 ED encounters). The risk of presenting with anxiety during the study period in 2020 compared to prior 3 years was 1.40 (95% confidence interval [CI] 1.21–1.63), for depression was 1.47 (95% CI 1.28–1.69), and for suicidal ideation was 1.05 (95% CI 0.90–1.23). There was an increase in admissions for depression during the pandemic period (15.2% increase, 95% CI 4.6%–25.7%). Conclusion There was a relative increase in patients presenting to the ED with complaints of anxiety and depression during the height of the COVID‐19 pandemic, while absolute numbers remained stable. Our results highlight the importance of acute care‐based mental health resources and interventions to support patients during this pandemic.