Police-referred psychiatric emergency presentations during the first and second wave of COVID-19 in Berlin, Germany: a retrospective chart review

Abstract

Background Literature on psychiatric emergency services (PES) presentations during the COVID-19 pandemic showed heterogeneous results regarding patients brought in by police (BIBP). This is the first study primarily focusing on patients BIBP in a PES during the COVID-19-period. Methods Case documentation records during the first and second wave of the COVID-19 pandemic in a PES in Berlin, Germany were analyzed using descriptive data analysis and binomial logistic regression analysis to detect factors that predict presentations BIBP. Results 5440 PES presentations: 2.4% BIBP during the first wave vs. 16.3% during its control period; second wave: 17.6% BIBP vs. 14.9% during its control period. In both waves, absolute increases in presentations BIBP were seen compared to control (p = .029, p = .028, respectively). COVID-19-period was a predictor for presentations BIBP during the first wave, when associated with inpatient admission or diagnosis of schizophrenia and psychotic disorders. No COVID-19 associated effects were found during the second wave. The following factors predicted presentations BIBP independently of COVID-19: younger age, male gender, inpatient admissions, aggressive behavior, suicide attempt prior to presentation and diagnosis of substance use disorders; depressive disorders were negatively associated. Conclusions During the COVID-19 pandemic, there was an increase in PES presentations BIBP. During the first wave (not the second wave), patients with schizophrenia and psychotic disorders were especially at risk of presentations BIBP. As outpatient facilities were less available during the first wave, which normalized during the second wave, this might be an explaining factor and should be a caveat for future pandemics. Additionally, general factors predicting PES presentations BIBP are reported that replenish the present literature.