COVID-19 and Pediatric Mental Health Hospitalizations

• Published in: Pediatrics (Evanston) 2023-05, Vol.151 (5)
• Main Authors: Khan, Jahidur Rahman, Hu, Nan, Lin, Ping-I, Eapen, Valsamma, Nassar, Natasha, John, James, Curtis, Jackie, Rimmer, Maugan, O'Leary, Fenton, Vernon, Barb, Lingam, Raghu
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Australia - epidemiology; Bayes Theorem; Bayesian analysis; Child; Child & adolescent mental health; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - therapy; Eating disorders; Emergency medical care; Emergency Service, Hospital; Female; Hospitalization; Hospitals, Pediatric; Humans; Mathematical models; Mental disorders; Mental Health; Pandemics; Pediatrics; Restrictions; Retrospective Studies; Self destructive behavior; Self-injury
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2022-058948

To analyze Australian national data to examine the impact of the coronavirus disease 2019 (COVID-19) pandemic on mental health-related hospital presentations among children and adolescents during the pandemic period with restrictions, and the period after the restrictions eased. We analyzed the monthly mental health-related inpatient admissions and emergency department (ED) attendances data from 6 large pediatric hospitals across Australia, using the Bayesian structural time series models. The COVID-19 restriction period was from March 2020 to December 2021 and the COVID-19 restriction-eased period from January to June 2022. A total of 130 801 mental health-related hospital admissions (54 907) and ED attendances (75 894) were analyzed. During the COVID-19 restriction period, there was a significant increase in inpatient admissions related to deliberate self-harm behaviors (82%, 95% credible interval [CrI], 7%-160%) and ED attendances related to overall mental health disorders (15%, 95% CrI, 1.1%-30%) and eating disorders (76%, 95% CrI, 36%-115%). The increase was higher among females and those living in the least socioeconomically disadvantaged areas, suggesting a widening gap between mental health-related presentations by sex and socioeconomic status. After the restrictions eased, there were slight declines in mental health-related hospital presentations; however, the numbers remained higher than the pre-COVID-19 levels. The increase in mental health-related hospital presentations during the COVID-19 period calls for additional support for pediatric mental health care, particularly for eating disorders and deliberate self-harm among female adolescents. It is important to monitor pediatric mental health service use as we enter "COVID-19 normal" period.