Impact of the COVID-19 pandemic on mental healthcare consultations among children and adolescents in Norway: a nationwide registry study

Abstract

The COVID-19 pandemic and its associated restrictions may have affected children and adolescent’s mental health adversely. We cast light on this question using primary and specialist consultations data for the entire population of children of age 6–19 years in Norway (N = 908 272). Our outcomes are the monthly likelihood of having a consultation or hospitalization related to mental health problems and common mental health diagnoses. We compared a pandemic (2019–2021) to a pre-pandemic (2017–2019) cohort using event study and difference-in-difference designs that separate the shock of the pandemic from linear period trends and seasonal variation. We found temporary reductions in all mental health consultations during lockdown in spring 2020. In fall 2020 and winter 2021, consultation volumes in primary care increased, stabilizing at a higher level in 2021. Consultations in specialist care increased from spring 2021. Our findings could suggest a worsening of mental health among adolescents.

Hospitalizations Associated With Mental Health Conditions Among Adolescents in the US and France During the COVID-19 Pandemic

“…1,[21][22][23][24] The greater illness burden observed among female adolescents is also in line with findings reported in other analyses. 1,8,24 These patterns have been documented primarily within individual countries and especially in single-center studies; few robust data exist across multicenter and international settings. Importantly, specific mitigation strategies and timing of containment measures differed across countries throughout the pandemic.…”

“…Our results are consistent with prior studies, highlighting the potential association of pandemic-related disruptions with adolescent social, emotional, and behavioral well-being . The greater illness burden observed among female adolescents is also in line with findings reported in other analyses .…”

The COVID-19 pandemic’s impact on mental health care use among Norwegian students in higher education: a nation-wide register-based pre-post cohort study

“…The increase in mental health consultations in primary care is substantially larger than what is found for slightly younger adolescents in Norway (aged 16-19) in a similar design. 25 However, in this study the modest effects among high school students could in part be linked to that the requirement of GP certi cation for sickness absence was relaxed in this age group during the pandemic. It is also possible that the students new to higher education and just starting their lives as young adults were particularly vulnerable to detrimental mental health effects of social distancing.…”

“…2,[5][6][7][8][9] In line with other studies on use of health services during the pandemic, we show that the level of mental health consultations was reduced relative to previous years in the spring of 2020. [25][26][27] This nding is, however, in contrast to survey studies that reported higher prevalence than before of psychological distress, including symptoms such as stress, anxiety, sleep pattern disruption, and depressive thoughts, at the beginning of the pandemic. 5 A diagnostic populationbased study for Norway for the same period, on the other hand, found no increase during lock-down 28 , suggesting that the higher prevalence is restricted to symptoms and/or differs between the general population and convenience samples.…”

The Global Impact of COVID-19 on Threat Appraisals

“…Accordingly, there will probably be a compelling need to readapt existence structures or even develop new outpatient facilities for psychological counselling of fragile people who may bear the mental consequences of the pandemic for many years. Additional strategies could also be urgently planned to face an increased burden of threat appraisals, such as changes in consultation practice, by implementing or potentiating online counselling [ 16 ].…”