Impact of the COVID-19 Pandemic on Psychiatric Admissions to a Large Swiss Emergency Department: An Observational Study

Abstract

The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency with profound mental health consequences. The psychiatric emergency department (ED) plays a key role during this mental health crisis. This study aimed to investigate differences in admissions at a Swiss psychiatric ED from 1 April to 15 May during a “pandemic-free” period in 2016 and a “during-pandemic” period in 2020. The study included 579 consultations at psychiatric ED in the “during-pandemic” period and 702 in the “pandemic-free” period. Sociodemographic and clinical characteristics were compared, and logistic regression analysis was performed to identify variables associated with psychiatric admissions during the pandemic. A reduction in total psychiatric ED admissions was documented during COVID-19. Logistic regression analysis predicted the independent variable (ED admission during the pandemic) and estimated odds ratio (OR) for being unmarried/not in a relationship, arrival in an ambulance, suicidal behavior, behavioral disorders and psychomotor agitation. Though only statistically significant in bivariate analysis, patients were also more likely to be involuntarily hospitalized. This picture appears to be reversed from a sociodemographic and clinical point of view to our observation of psychiatric ED consultation in 2016. These findings highlight that the reduction in psychiatric ED admissions during the pandemic seems to be associated with living alone and more severe psychopathologies, which must alert psychiatrists to ensure access to mental health care in times of pandemic.

Emergency Psychiatric Consultations During and After the COVID-19 Lockdown in Italy. A Multicentre Study

“…Over the period examined, there was a 30% reduction in HED psychiatric consultations in 2020 compared with 2019. This reduction in psychiatric consultations in the early stages of the pandemic is consistent with evidence from other countries (4)(5)(6)(7)(8)(9)(10)(11).…”

“…In general, projections indicate an increase in depression and post-traumatic stress disorder (PTSD) on a basis of biological mechanisms and social consequences (2,3). On the other hand, some preliminary reports on mental health management in the acute phase of the pandemic have found a decrease in requests for psychiatric consultations in hospital emergency departments (HEDs) (4)(5)(6)(7)(8)(9)(10)(11). Clearly, the type of organization of mental health care has a strong influence on how each country copes with the crisis.…”

Impact of COVID-19 pandemic on involuntary and urgent inpatient admissions for psychiatric disorders in a German-wide hospital network

“…In the current study, it is shown for the first time in a large inpatient sample (total n = 64,502) that the proportion of urgent and involuntary admissions for all psychiatric diagnoses significantly increased in 2020 as compared to 2018 and 2019. This increase might have been caused by a focus on acute psychiatric care due to shifting of health care towards COVID-19 treatment ( Ambrosetti et al, 2021 ; Bojdani et al, 2020 ). Restrictions imposed by governments might have tightened admission criteria for less urgent admissions and led to a relative increase in the proportion of urgent and involuntary admissions even though psychiatric wards are a more independent department from the rest of the tertiary care system ( Fasshauer et al, 2021b ).…”

“…In Germany, the partial lockdown decreased number of emergency hospital admissions for psychiatric disorders ( Fasshauer et al, 2021a ). Some evidence exists that acute and involuntary admissions increased during the first lockdown ( Ambrosetti et al, 2021 ; Carpiniello et al, 2020 ; Itrat et al, 2020 ; Tromans et al, 2020 ).…”

Hopelessness and Post-Traumatic Stress Symptoms among Healthcare Workers during the COVID-19 Pandemic: Any Role for Mediating Variables?

“…Therefore, the governments of each nation hypothesized the negative socio-economic impact of the pandemic with detrimental consequences on local and worldwide health services [1]. For this reason, most governments obliged the general population to several security measures, including quarantine, lockdown, and confinement [2,3].…”