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 cli-mate is deleterious to mental health and may increase demand for mental health services in emergency depart-ments. 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 emer-gency department encounters attributed to mental health. We performed chi-square analyses to evaluate the dif-ferences between 2019 and 2020. Results: We found that overall emergency department volume declined between 2019 and 2020, while the pro-portion attributable to mental health conditions increased (p < 0.01). Substance abuse, anxiety, and mood disor-ders 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 im-perative 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. (c) 2021 Elsevier Inc. All rights reserved.

Automated summary

This study found that the proportion of emergency department encounters attributed to mental health conditions increased after the COVID-19 outbreak. Substance abuse, anxiety, and mood disorders were the main types of mental health diagnoses. Emergency departments play a crucial role in identifying and triaging mental health emergencies, especially during disasters and extended crises.