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Table 1 Conclusion There was an increase in the number of CYP presenting to PED with MH crisis from 2019 to 2021. The number of children admitted to our acute paediatric ward in 2021 nearly doubled from 2019, suggesting a possible deterioration of CYP MH during the pandemic. This seems consistent with national data from 2020 following the first wave of COVID-19. 2 Throughout 2019 and 2021, the majority of admitted patients were previously known to CAMHS, yet were still presenting to PED. This may reflect accessibility issues due to reduced capacity of community CAMHS as an indirect effect of the pandemic.Our findings highlight the concerning increase in admissions of CYP due to overdose since the start of COVID-19, reflecting the vulnerability and lack of support services for children in inner cities. Lastly, we have demonstrated an increase in the burden on acute paediatric wards, imposing logistical pressures on bed management, personnel, patient environment and cost. These effects warrant immediate, careful consideration in the context of public health as well as CAMHS provision in primary and secondary care.

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