Perceived impact of the COVID-19 pandemic on child and adolescent psychiatric services after 1 year (February/March 2021): ESCAP CovCAP survey

Abstract

In April 2020, the European Society for Child and Adolescent Psychiatry (ESCAP) Research Academy and the ESCAP Board launched the first questionnaire of the CovCAP longitudinal survey to estimate the impact of COVID-19 on child and adolescent psychiatry (CAP) services in Europe. In this brief report, we present the main findings from the second questionnaire of the survey, one year after the COVID-19 pandemic began to hit Europe (i.e., February/March 2021). While service delivery to patients and their families was affected in a major way (reported by 68%) at the beginning of the pandemic, the majority of respondents (59%) in this second survey only reported a minor impact on care delivery. The use of telemedicine remained widespread (91%) but the proportion of CAP services partially closed or transformed to accommodate COVID-19 patients (59% in 2020) dropped to 20%. On the other hand, the perceived impact on the mental health and psychopathology of children and adolescents dramatically increased from “medium” (> 50%) in 2020 to “strong” or “extreme” (80%) in 2021. Four nosographic entities were particularly impacted: suicidal crises, anxiety disorders, eating disorders and major depressive episodes. Accordingly, this was associated with a substantial increase in the number of referrals or requests for assessments (91% reported an increase in 2021 while 61% reported a decrease in 2020). Finally, heads of the CAP departments expressed strong concerns regarding the management of the long-term consequences of this crisis, especially regarding the provision of care in light of the perceived increase in referrals. Supplementary Information The online version contains supplementary material available at 10.1007/s00787-021-01851-1.

The Impact of the COVID-19 Pandemic on Mental Health Care of Children and Adolescents in Switzerland: Results of a Survey among Mental Health Care Professionals after One Year of COVID-19

“…The observation of a delayed but alarming increase in treatment demand up to January/February/March 2021 was confirmed by the analysis of electronic patient records prior and during the COVID-19 pandemic from the emergency outpatient facility of the Department of Child and Adolescent Psychiatry and Psychotherapy in the Psychiatric University Hospital Zurich [ 20 ]. These findings also correspond to reports from some other European countries [ 8 , 9 ], although data on the number of outpatient treatments are not consistent. In a survey of European clinics for child and adolescent psychiatry, respondents more often indicated that the number of outpatients decreased (N = 21) rather than increased (N = 10) in February/March 2021, compared to before the pandemic [ 8 ].…”

“…For spring 2020, only a small proportion of respondents (generally less than 30%) reported an increased prevalence occurrence of certain disorders, such as anxiety or obsessive compulsive disorders. By contrast, for February/March 2021, the vast majority of respondents reported increased numbers of cases with anxiety disorders (70%), depression (>60%), eating disorders (>60%), and suicidal crises (>80%) [ 8 ]. Data from the Republic of Ireland [ 9 ] indicate that referrals to specialized child and adolescent mental health services dropped by around 10% up to August 2020 and then steadily increased up to December 2020, reaching 180% compared to previous years, with double the number of outpatient appointments compared to previous years.…”

Increase in depression and anxiety disorder diagnoses during the COVID-19 pandemic in children and adolescents followed in pediatric practices in Germany

“…Finally, many services were provided by telephone or video contact (22). Revet et al estimated the impact of COVID-19 on child and adolescent psychiatry services in Europe and they reported that the perceived impact on the mental health and psychopathology of children and adolescents dramatically increased in 2020 and 2021 (11).…”

“…We used the classification we had often seen in other studies as we thought it was correct: small children (0-5 years), school children (6-12 years) and adolescents (13-17 years). However, we also further stratified 6-12-year-olds into two groups (6)(7)(8)(9)(10)(11)(12) as this makes a difference between children attending primary school (first 4 years) and those attending secondary school in Germany-primary schools were not closed for as long as secondary schools.…”

“…The coronavirus pandemic and lockdowns also impacted the daily lives of children and youth, partly due to the closure of schools and the absence of outdoor activities. A number of Asian and European studies have shown that a significant proportion of children and adolescents are suffering from mental health problems as a result of the coronavirus pandemic or the related measures (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17).…”