Trends in US Emergency Department Visits for Mental Health, Overdose, and Violence Outcomes Before and During the COVID-19 Pandemic

Holland, Kristin M.; Jones, Christopher M.; Vivolo-Kantor, Alana M.; Idaikkadar, Nimi; Zwald, Marissa; Hoots, Brooke; Yard, Ellen E.; D’Inverno, Ashley S.; Swedo, Elizabeth A.; Chen, May S.; Petrosky, Emiko; Board, Amy; Martínez, Pedro Daniel; Stone, Deborah M.; Law, Royal; Coletta, Michael; Adjemian, Jennifer; Thomas, Cheryll C.; Puddy, Richard W.; Peacock, Georgina; Dowling, Nicole F.; Houry, Debra

doi:10.1001/jamapsychiatry.2020.4402

Cited by 465 publications

(501 citation statements)

References 25 publications

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“…Overall, there is accumulating evidence on the negative consequences of the COVID-19 pandemic on public mental health. A number of cross-sectional and longitudinal cohort studies have found detrimental effects of the pandemic on various mental health domains, including psychological distress, depression, anxiety, and an increase of more distal risk factors such as cannabis and alcohol misuse and loneliness [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. These findings are largely in line with findings from this nationally representative survey, i.e., high levels of social isolation, lack of company, COVID-19-related worrying, and anxiety have been reported and found to impact psychological distress in youth during active lockdown in Germany.…”

Section: Discussionmentioning

confidence: 99%

Social isolation, mental health, and use of digital interventions in youth during the COVID-19 pandemic: a nationally representative survey

Rauschenberg¹,

Schick²,

Goetzl³

et al. 2020

Preprint

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Background: Public health measures to curb SARS-CoV-2 transmission rates may have negative psychosocial consequences in youth. Digital interventions may help to mitigate these effects. We aimed to investigate the associations between social isolation, COVID-19-related worries/anxieties, objective social risk indicators, psychological distress and use of digital mobile health (mHealth) interventions in youth during the COVID-19 pandemic.Methods: Data were collected as part of the “Health And Innovation During COVID-19 Survey” —a cross-sectional panel study including a representative sample of individuals aged 16 to 25 years (N=666; Mage 21·3) (assessment period: 07.05.-16.05.2020). Data were collected on social isolation, COVID-19-related worries/anxieties, objective social risk indicators, psychological distress as well as the current use of and attitude towards digital interventions.Outcomes: Social isolation, lack of company, worrying, and objective social risk indicators were associated with psychological distress during the COVID-19 pandemic. Dose-response relationships were found. For instance, psychological distress was progressively more likely to occur as levels of reported social isolation increased (with reporting ‘never’ as reference group: ‘very rarely’: adjusted odds ratio [aOR] 2·4,CI 1·0 – 5·7, p=0·041; ‘rarely’: aOR 3·6, CI 1·7 – 7·7, p=0·001; ‘occasionally’: aOR 8·4, CI 4·0 – 17·5, p<0·001; ‘often’: aOR 20·6, CI 9·3 – 45·7, p<0·001;’very often’: aOR 43·4, CI 14·7 – 128·2, p<0·001). There was evidence that psychological distress, and high levels of social isolation, lack of company, and worrying were associated with a positive attitude towards using digital interventions, whereas only severe levels of psychological distress and worries were associated with actual use (aOR 2·0, CI 1·3 - 3·0, p=0·001; aOR 1·6, CI 1·1 – 2·2, p=0·005, respectively).Interpretation: Public health measures during pandemics may be associated with social isolation and poor mental health outcomes in youth. Digital interventions may help mitigate the negative psychosocial impact without risk for viral infection given there is an objective need and subjective demand.

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Section: Discussionmentioning

confidence: 99%

Social isolation, mental health, and use of digital interventions in youth during the COVID-19 pandemic: a nationally representative survey

Rauschenberg¹,

Schick²,

Goetzl³

et al. 2020

Preprint

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“…COVID-19 may influence the methods in which individuals use substances and their risk for fatal and nonfatal overdoses. When contrasting median emergency department rates from 2019 and 2020, data from the Centers for Disease Control and Prevention's National Syndromic Surveillance Program revealed a significant increase in overdoses for opioids and for all substances in 2020 compared with 2019 [ 15 ▪ ]. Additionally, National Emergency Medical Services Information System (NEMSIS) data found that rates of overdose-related cardiac arrests per emergency medical services activations were elevated in 2020 compared with 2019 and 2018 [ 16 ▪▪ ].…”

Section: Overdose Riskmentioning

confidence: 99%

Converging public health crises: substance use during the coronavirus disease 2019 pandemic

Striley

Hoeflich

2021

Current Opinion in Psychiatry

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Purpose of review The international, public health crisis caused by the rapid spread of SARS-CoV-2 has resulted in unforeseen medical and psychiatric consequences. We reviewed publications from January 2020 to January 2021, given that earlier documents were not relevant, to review findings on changes in substance use and overdoses during the pandemic. Additionally, this review of the literature also documents advocacy efforts, health service modification and challenges, as well as COVID-related health complications associated with substance use. Recent findings Recent work focused on identifying changes in the distribution and use of substances as well as the unique challenges to promoting the health of persons who use substances in the current pandemic. Although COVID-19 has triggered unprecedented innovations in the organizational and public policy, the use of certain substances (alcohol, cannabis, cigarettes, fentanyl, heroin, and opiates) is increasing internationally. Unique associations between substance use and pandemic-related adverse health outcomes were identified. In addition, the pandemic precipitated significant barriers and disruptions to care. Summary Given increased overdose rates and infections among people who use drugs, continued surveillance and vigilance are needed to assess changes and reduce use and adverse consequences during the continuing COVID-19 crisis. Changes are urgently needed to reduce adverse health outcomes because of treatment barriers and lack of adequate treatment options. Additionally, integrative approaches are necessary to promote the public health of persons who use substances.

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“…The opioid and COVID-19 epidemics have collectively precipitated an increase in opioid-related mortality in 2020 [ 1 ]. More than 3500 Emergency Departments (ED) in the United States reported that opioid overdoses consistently increased in 2020 compared to 2019 [ 2 ]. Prior to COVID-19, strict state and federal regulations and laws (in the United States) such as The Ryan Haight Act of 2008, the Drug Addiction Treatment Act of 2000, and 42 CFR 8 for opioid treatment programs (OTPs) enforced by the Substance Abuse and Mental Health Service Administration and Drug Enforcement Agency made opioid treatment difficult, time consuming, and costly for patients to access and receive medication and care.…”

Section: Introductionmentioning

confidence: 99%

Medication for Opioid Use Disorder Service Provision and Telephone Counseling: A Concurrent Mixed-Methods Approach

Martin

Kang

DeBritz

et al. 2021

IJERPH

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Using quantitative and qualitative evidence, this study triangulates counselors’ perspectives on the use of telemedicine in the context of Opioid Use Disorder (OUD) treatment. A concurrent mixed-methods design examined counselors’ experiences with telephone counseling during the COVID-19 pandemic. N = 42 counselors who provided OUD counseling services completed a close-ended, quantitative survey examining their experiences in addressing clients’ anxiety, depression, anger, substance use, therapeutic relationship, and substance use recovery using telephone counseling. The survey also assessed comfort, convenience, and satisfaction with telephone counseling. Counselors also completed open-ended responses examining satisfaction, convenience, relationship with patients, substance use, and general feedback with telephone counseling. The synthesis of quantitative and qualitative evidence indicated that a majority of counselors had positive experiences with using telephone counseling to provide services to clients undergoing OUD treatment. Convenience, greater access to clients, and flexibility were among the reasons cited for their positive experience. However, counselors also expressed that the telephone counseling was impersonal, and that some clients may have difficulties accessing appropriate technology for telehealth adoption. Findings suggest that further research with counselors is needed to identify the key elements of an effective integration of telephone counseling with traditional in-person treatment approaches in the post-pandemic era.

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Trends in US Emergency Department Visits for Mental Health, Overdose, and Violence Outcomes Before and During the COVID-19 Pandemic

Cited by 465 publications

References 25 publications

Social isolation, mental health, and use of digital interventions in youth during the COVID-19 pandemic: a nationally representative survey

Social isolation, mental health, and use of digital interventions in youth during the COVID-19 pandemic: a nationally representative survey

Converging public health crises: substance use during the coronavirus disease 2019 pandemic

Medication for Opioid Use Disorder Service Provision and Telephone Counseling: A Concurrent Mixed-Methods Approach

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