Acute mental health service use following onset of the COVID-19 pandemic in Ontario, Canada: a trend analysis.

Autor: Saunders NR; Department of Paediatrics (Saunders, Toulany, Guttmann), University of Toronto, Toronto, Ont.; The Hospital for Sick Children (Toulany), Toronto, Ont.; Child Health Evaluative Sciences (Saunders, Toulany), SickKids Research Institute, Toronto, Ont.; ICES (Saunders, Deb, Strauss, Vigod, Guttmann, Chiu, Huang, Fung, Chen), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Vigod, Chiu, Kurdyak), University of Toronto, Toronto, Ont.; Edwin S.H. Leong Centre for Healthy Children (Guttmann), University of Toronto, Toronto, Ont.; Women's College Hospital and Women's College Research Institute (Vigod, Kurdyak), Toronto, Ont.; Department of Psychiatry (Vigod, Kurdyak), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont. Natasha.saunders@sickkids.ca., Toulany A; Department of Paediatrics (Saunders, Toulany, Guttmann), University of Toronto, Toronto, Ont.; The Hospital for Sick Children (Toulany), Toronto, Ont.; Child Health Evaluative Sciences (Saunders, Toulany), SickKids Research Institute, Toronto, Ont.; ICES (Saunders, Deb, Strauss, Vigod, Guttmann, Chiu, Huang, Fung, Chen), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Vigod, Chiu, Kurdyak), University of Toronto, Toronto, Ont.; Edwin S.H. Leong Centre for Healthy Children (Guttmann), University of Toronto, Toronto, Ont.; Women's College Hospital and Women's College Research Institute (Vigod, Kurdyak), Toronto, Ont.; Department of Psychiatry (Vigod, Kurdyak), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont., Deb B; Department of Paediatrics (Saunders, Toulany, Guttmann), University of Toronto, Toronto, Ont.; The Hospital for Sick Children (Toulany), Toronto, Ont.; Child Health Evaluative Sciences (Saunders, Toulany), SickKids Research Institute, Toronto, Ont.; ICES (Saunders, Deb, Strauss, Vigod, Guttmann, Chiu, Huang, Fung, Chen), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Vigod, Chiu, Kurdyak), University of Toronto, Toronto, Ont.; Edwin S.H. Leong Centre for Healthy Children (Guttmann), University of Toronto, Toronto, Ont.; Women's College Hospital and Women's College Research Institute (Vigod, Kurdyak), Toronto, Ont.; Department of Psychiatry (Vigod, Kurdyak), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont., Strauss R; Department of Paediatrics (Saunders, Toulany, Guttmann), University of Toronto, Toronto, Ont.; The Hospital for Sick Children (Toulany), Toronto, Ont.; Child Health Evaluative Sciences (Saunders, Toulany), SickKids Research Institute, Toronto, Ont.; ICES (Saunders, Deb, Strauss, Vigod, Guttmann, Chiu, Huang, Fung, Chen), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Vigod, Chiu, Kurdyak), University of Toronto, Toronto, Ont.; Edwin S.H. Leong Centre for Healthy Children (Guttmann), University of Toronto, Toronto, Ont.; Women's College Hospital and Women's College Research Institute (Vigod, Kurdyak), Toronto, Ont.; Department of Psychiatry (Vigod, Kurdyak), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont., Vigod SN; Department of Paediatrics (Saunders, Toulany, Guttmann), University of Toronto, Toronto, Ont.; The Hospital for Sick Children (Toulany), Toronto, Ont.; Child Health Evaluative Sciences (Saunders, Toulany), SickKids Research Institute, Toronto, Ont.; ICES (Saunders, Deb, Strauss, Vigod, Guttmann, Chiu, Huang, Fung, Chen), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Vigod, Chiu, Kurdyak), University of Toronto, Toronto, Ont.; Edwin S.H. Leong Centre for Healthy Children (Guttmann), University of Toronto, Toronto, Ont.; Women's College Hospital and Women's College Research Institute (Vigod, Kurdyak), Toronto, Ont.; Department of Psychiatry (Vigod, Kurdyak), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont., Guttmann A; Department of Paediatrics (Saunders, Toulany, Guttmann), University of Toronto, Toronto, Ont.; The Hospital for Sick Children (Toulany), Toronto, Ont.; Child Health Evaluative Sciences (Saunders, Toulany), SickKids Research Institute, Toronto, Ont.; ICES (Saunders, Deb, Strauss, Vigod, Guttmann, Chiu, Huang, Fung, Chen), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Vigod, Chiu, Kurdyak), University of Toronto, Toronto, Ont.; Edwin S.H. Leong Centre for Healthy Children (Guttmann), University of Toronto, Toronto, Ont.; Women's College Hospital and Women's College Research Institute (Vigod, Kurdyak), Toronto, Ont.; Department of Psychiatry (Vigod, Kurdyak), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont., Chiu M; Department of Paediatrics (Saunders, Toulany, Guttmann), University of Toronto, Toronto, Ont.; The Hospital for Sick Children (Toulany), Toronto, Ont.; Child Health Evaluative Sciences (Saunders, Toulany), SickKids Research Institute, Toronto, Ont.; ICES (Saunders, Deb, Strauss, Vigod, Guttmann, Chiu, Huang, Fung, Chen), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Vigod, Chiu, Kurdyak), University of Toronto, Toronto, Ont.; Edwin S.H. Leong Centre for Healthy Children (Guttmann), University of Toronto, Toronto, Ont.; Women's College Hospital and Women's College Research Institute (Vigod, Kurdyak), Toronto, Ont.; Department of Psychiatry (Vigod, Kurdyak), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont., Huang A; Department of Paediatrics (Saunders, Toulany, Guttmann), University of Toronto, Toronto, Ont.; The Hospital for Sick Children (Toulany), Toronto, Ont.; Child Health Evaluative Sciences (Saunders, Toulany), SickKids Research Institute, Toronto, Ont.; ICES (Saunders, Deb, Strauss, Vigod, Guttmann, Chiu, Huang, Fung, Chen), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Vigod, Chiu, Kurdyak), University of Toronto, Toronto, Ont.; Edwin S.H. Leong Centre for Healthy Children (Guttmann), University of Toronto, Toronto, Ont.; Women's College Hospital and Women's College Research Institute (Vigod, Kurdyak), Toronto, Ont.; Department of Psychiatry (Vigod, Kurdyak), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont., Fung K; Department of Paediatrics (Saunders, Toulany, Guttmann), University of Toronto, Toronto, Ont.; The Hospital for Sick Children (Toulany), Toronto, Ont.; Child Health Evaluative Sciences (Saunders, Toulany), SickKids Research Institute, Toronto, Ont.; ICES (Saunders, Deb, Strauss, Vigod, Guttmann, Chiu, Huang, Fung, Chen), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Vigod, Chiu, Kurdyak), University of Toronto, Toronto, Ont.; Edwin S.H. Leong Centre for Healthy Children (Guttmann), University of Toronto, Toronto, Ont.; Women's College Hospital and Women's College Research Institute (Vigod, Kurdyak), Toronto, Ont.; Department of Psychiatry (Vigod, Kurdyak), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont., Chen S; Department of Paediatrics (Saunders, Toulany, Guttmann), University of Toronto, Toronto, Ont.; The Hospital for Sick Children (Toulany), Toronto, Ont.; Child Health Evaluative Sciences (Saunders, Toulany), SickKids Research Institute, Toronto, Ont.; ICES (Saunders, Deb, Strauss, Vigod, Guttmann, Chiu, Huang, Fung, Chen), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Vigod, Chiu, Kurdyak), University of Toronto, Toronto, Ont.; Edwin S.H. Leong Centre for Healthy Children (Guttmann), University of Toronto, Toronto, Ont.; Women's College Hospital and Women's College Research Institute (Vigod, Kurdyak), Toronto, Ont.; Department of Psychiatry (Vigod, Kurdyak), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont., Kurdyak P; Department of Paediatrics (Saunders, Toulany, Guttmann), University of Toronto, Toronto, Ont.; The Hospital for Sick Children (Toulany), Toronto, Ont.; Child Health Evaluative Sciences (Saunders, Toulany), SickKids Research Institute, Toronto, Ont.; ICES (Saunders, Deb, Strauss, Vigod, Guttmann, Chiu, Huang, Fung, Chen), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Vigod, Chiu, Kurdyak), University of Toronto, Toronto, Ont.; Edwin S.H. Leong Centre for Healthy Children (Guttmann), University of Toronto, Toronto, Ont.; Women's College Hospital and Women's College Research Institute (Vigod, Kurdyak), Toronto, Ont.; Department of Psychiatry (Vigod, Kurdyak), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont.
Jazyk: angličtina
Zdroj: CMAJ open [CMAJ Open] 2021 Nov 16; Vol. 9 (4), pp. E988-E997. Date of Electronic Publication: 2021 Nov 16 (Print Publication: 2021).
DOI: 10.9778/cmajo.20210100
Abstrakt: Background: The extent to which heightened distress during the COVID-19 pandemic translated to increases in severe mental health outcomes is unknown. We examined trends in psychiatric presentations to acute care settings in the first 12 months after onset of the pandemic.
Methods: This was a trends analysis of administrative population data in Ontario, Canada. We examined rates of hospitalizations and emergency department visits for mental health diagnoses overall and stratified by sex, age and diagnostic grouping (e.g., mood disorders, anxiety disorders, psychotic disorders), as well as visits for intentional self-injury for people aged 10 to 105 years, from January 2019 to March 2021. We used Joinpoint regression to identify significant inflection points after the onset of the pandemic in March 2020.
Results: Among the 12 968 100 people included in our analysis, rates of mental health-related hospitalizations and emergency department visits declined immediately after the onset of the pandemic (peak overall decline of 30% [hospitalizations] and 37% [emergency department visits] compared to April 2019) and returned to near prepandemic levels by March 2021. Compared to April 2019, visits for intentional self-injury declined by 33% and remained below prepandemic levels until March 2021. We observed the largest declines in service use among adolescents aged 14 to 17 years (55% decline in hospitalizations, 58% decline in emergency department visits) and 10 to 13 years (56% decline in self-injury), and for those with substance-related disorders (33% decline in emergency department visits) and anxiety disorders (61% decline in hospitalizations).
Interpretation: Contrary to expectations, the abrupt decline in acute mental health service use immediately after the onset of the pandemic and the return to near prepandemic levels that we observed suggest that changes and stressors in the first 12 months of the pandemic did not translate to increased service use. Continued surveillance of acute mental health service use is warranted.
Competing Interests: Competing interests: Natasha Saunders reports receiving an editorial honorarium from Archives of Diseases in Childhood and an honorarium from the M.S.I. Foundation, outside the submitted work. Simone Vigod reports receiving royalties from Up To Date, outside the submitted work.
(© 2021 CMA Joule Inc. or its licensors.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje