Impact of the COVID-19 pandemic on adult mental health-related admissions at a large university health system in North Carolina – one year into the pandemic

Abstract

Objective Pandemic-associated stress may have exacerbated preexisting mental health and substance use disorders (MH/SUD) and caused new MH/SUD diagnoses which would be expected to lead to an increase in visits to emergency departments and hospital admissions for these conditions. This study assessed whether the proportion of hospital and emergency department encounters for MH/SUD diagnoses increased during the first year of the COVID-19 pandemic in the United States. Methods We conducted a longitudinal (interrupted time series) analysis of 994,724 eligible encounters identified by electronic query between January 1, 2016 and March 31, 2021. Of these, 55,574 encounters involved MH/SUD diagnosis. The pre-pandemic period was defined as January 1, 2016 to March 31, 2020, and the pandemic period was defined as April 1, 2020 to March 31, 2021. All statistical analyses were performed with R. Results No significant trend in MH/SUD encounters at baseline (rate ratio 1.00, 95% CI 0.99–1.01, p = 0.75) was observed. However, the onset of the pandemic was temporally associated with a significant level increase in the proportion of MH/SUD encounters relative to overall encounters (rate ratio 1.14, 95% CI 1.06–1.21, p<0.001) with no change in the overall trend (rate ratio 0.99, 95% CI 0.90–1.10, p = 0.89). Conclusions The significant pandemic-associated increase in the proportion of MH/SUD encounters relative to overall encounters was driven largely by sustained numbers of MH/ SUD encounters despite a decrease in total encounters. Increased support for mental health care is needed for these vulnerable patients during pandemics.

Impact of the SARS-CoV-2 Pandemic on Hospitalizations in an Acute Psychiatric Ward

“…We also observed an increased number of non-Italians among hospitalized subjects during the pandemic, probably due to the lack of a social and familial network, as well as people with SA and disability pensions, probably because of their limited autonomy during the stressful conditions of the pandemic, as underscored by other authors. 10 , 26 , 27 Furthermore, subjects who had already been admitted to SPDC in the past or who had been treated in more than one community service or with multiple drug addiction, were more frequently represented among people hospitalized during the pandemic, suggesting higher complexity and difficulty in clinically managing them during the pandemic. All these observations highlight that conditions of social stress such as those created by the SARS-CoV-2 epidemic amplify the vulnerability of people already fragile and dependent on institutions, who require hospitalization due to the worsening of their pathological conditions.…”