Emergency department utilization for mental health conditions before and after the COVID-19 outbreak.
INTRODUCTION
The outbreak of COVID-19 disrupted lives across the United States. Evidence shows that such a climate is deleterious to mental health and may increase demand for mental health services in emergency departments. The purpose of this study was to determine the difference in emergency department utilization for mental health diagnoses before and after the COVID-19 surge.


METHODS
We conducted a cross-sectional study between January-August 2019 and January-August 2020 with emergency department encounter as the sampling unit. The primary outcome was the proportion of all emergency department encounters attributed to mental health. We performed chi-square analyses to evaluate the differences between 2019 and 2020.


RESULTS
We found that overall emergency department volume declined between 2019 and 2020, while the proportion attributable to mental health conditions increased (p < 0.01). Substance abuse, anxiety, and mood disorders accounted for nearly 90% of mental health diagnoses during both periods. When stratified by sex, substance abuse was the leading mental health diagnosis for males and anxiety and substance abuse disorders combined accounted for the largest proportion for females.


DISCUSSION
The emergency department is an important community resource for the identification and triage of mental health emergencies. This role is even more important during disasters and extended crises, making it imperative that emergency departments employ experienced mental health staff. This study provides a comparison of emergency department utilization for mental health diagnoses before the pandemic and during the spring 2020 surge and may serve as a useful guide for hospitals, health systems and communities in future planning.
['Stroever|Stephanie|S|', 'Brett|Chelsea|C|', 'Michael|Katherine|K|', 'Petrini|Joann|J|']
D000328:Adult D000368:Aged D001008:Anxiety Disorders D000086382:COVID-19 D016009:Chi-Square Distribution D003237:Connecticut D003430:Cross-Sectional Studies D004636:Emergency Service, Hospital D005260:Female D006801:Humans D008297:Male D001523:Mental Disorders D008875:Middle Aged D010342:Patient Acceptance of Health Care D012737:Sex Factors D019966:Substance-Related Disorders
Mental health COVID-19 Mental health services Hospital Emergency service