Trends in Psychiatric Emergency Department Visits in Northern Israel During the COVID-19 Outbreak

• Published in: Frontiers in psychiatry Vol. 12; p. 603318
• Main Authors: Pikkel Igal, Yael, Meretyk, Irit, Darawshe, Aziz, Hayek, Samer, Givon, Limor, Levy, Avi, Sipori, Idan, Nuriel, Yonatan, Bloch, Boaz, Buniak, Shraga, Eshel, Ron, Fruchter, Eyal
• Format: Journal Article
• Language: English
• Published: Frontiers Media S.A 20-07-2021
• Subjects: COVID-19; health seeking behavior; mental health; psychiatric emergency department visits; Psychiatry; suicide
• DOI: 10.3389/fpsyt.2021.603318
• EISSN: 1664-0640

Background:
During the spread of coronavirus disease (COVID-19), mandatory quarantines increased social isolation and anxiety, with inevitable consequences on mental health and health seeking behavior. We wished to estimate those trends.
Methods:
We examined all psychiatric visits to the emergency department (ED) during March, April 2020, compared to identical months in 2018, 2019. We evaluated both number and nature of referrals.
Results:
Throughout the years, psychiatric referrals comprised about 5% of the total number of ED visits. In March-April 2020, 30% decreases were observed in overall ED visits and in psychiatric referrals in the ED. Compared to 2018–2019, in 2020, the proportions of these diagnoses were higher: anxiety disorders (14.5 vs. 5.4%,
p
< 0.001), personality disorders (6.7 vs. 3.2%,
p
= 0.001), psychosis (9.5 vs. 6.7%,
p
= 0.049), post-traumatic stress disorder (3.2 vs. 1.5%,
p
= 0.023). Compared to 2018–2019, in 2020, proportions were lower for adjustment disorder (5.8 vs. 8.9%,
p
= 0.036) and for consultation regarding observation (11.7 vs. 31.6%,
p
< 0.001). Differences were not observed between 2018-2019 and 2020 in the proportions of other diagnoses including suicide and self-harm disorders. Referrals concerning suicide and self-harm in a rural hospital and community clinic were 30% lower in the COVID-19 lockdown than in the same months in 2018, 2019.
Conclusion:
Psychiatric ED visits decreased by the same proportion as overall visits to the ED, apparently driven by fears of COVID-19. Referrals relating suicidality and self-harm shown nominal decrease, but their proportioned share remained constant. Increased anxiety and delayed care may eventually lead to increased mental health needs.