The COVID-19 pandemic is a global health emergency, the scale, speed and nature of which is beyond anything most of us have experienced in our lifetimes. The mental health burden associated with this pandemic is also likely to surpass anything we have previously experienced. In this editorial, we seek to anticipate the nature of this additional mental health burden and make recommendations on how to mitigate against and prepare for this significant increase in mental health service demand.

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In 2014, more than 11,000 people came to Irish general hospital Emergency Departments following self-harm. It is known that up to 15% of patients who present following self-harm leave the Emergency Department (ED) without a bio-psycho-social (BPS) assessment of risk and need, and 17% will repeat their self-harm act within 3 months.Self-harm is the single biggest risk factor for completed suicide, increasing the risk of suicide This NCP requires that all patients presenting to ED with self-harm (including suicidal ideation and intent) receive standardised triage, bio-psycho-social assessment and assertive follow up by skilled clinicians.Family/carers will be included in the assessment and follow up process. The quality of the programme will be monitored through a set of key metrics.The objectives of this programme are to:

Objective: The Health Service Executive National Clinical Programme for Eating Disorders (NCPED) launched a Model of Care for Eating Disorder Services in Ireland in 2018. Currently, one adult and two child and adolescent eating disorder services are operational out of a total of sixteen recommended. The three objectives of this paper are to describe the early (1) referral pattern, (2) level of service activity and (3) the level of service user satisfaction. Method: Monthly submitted service activity data from each service to the NCPED between March 2018 and October 2020 were retrospectively analysed. One hundred and fifty-nine carers and service users completed an experience of service questionnaire (ESQ). A descriptive analysis of referral pattern, level of service activity and ESQ was performed. A thematic analysis was performed on three qualitative questions on the ESQ. Results: There was substantial referral numbers to eating disorder services by 18 months (n = 258). The main referral source was community mental health teams. The majority (n = 222, 86%) of referrals were offered an assessment. The most common age profile was 10–17 years of age (n = 120, 54.1%), and anorexia nervosa was the most common disorder (n = 96, 43.2%). ESQ results demonstrate that most service users were satisfied with their service, and the main themes were carer involvement, staff expertise, therapeutic alliance and service access. Conclusions: This preliminary service activity and service user satisfaction data highlight several issues, including trends when setting up a regional eating disorder service, potential pitfalls of pragmatic data collection and the need for adequate information-technology infrastructure.

BackgroundThe COVID‐19 pandemic experience was different in each country (e.g., prevalence, societal restrictions). There is limited data on eating disorder (ED) diagnosis and service activity trends within Ireland. The aim of this study is to describe the ED referral and hospitalization trends during COVID‐19 in Ireland.MethodMonthly data (2019–2021) from three regional community ED services (two‐child and one‐adult) were collected. National psychiatric and medical hospitalization data were analyzed. A descriptive and trend analysis was performed.ResultsThere was a trend of referrals to community ED services during the COVID‐19 pandemic for children (p < .0001) and adults (p = .0019). Albeit the increase in child referrals was evident at an earlier point before adult referrals. There was a trend of a diagnosis for children and adults of anorexia nervosa (p < .0001; p = .0257) and other‐specified‐feeding‐or‐eating‐disorder (OSFED) respectively (p = .0037; p = .0458). There was no trend in psychiatric co‐morbidity. There was a trend of child (p = .0003) not adult (n = 0.1669) psychiatric hospitalization. There was a trend of medical hospitalization for child and adult combined (p < .0001).ConclusionThis study adds to the growing literature on the association of the COVID‐19 pandemic on ED trends and the need for future public health and service provision funding to be allocated for mental health services during periods of international crisis.Public SignificanceThis study illustrates the referral and hospitalization trend in young persons and adults with an ED in Ireland during the COVID‐19 pandemic. This study highlights that there was a trend of Anorexia Nervosa and OSFED presentations during the COVID‐19 pandemic.