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Newberry-Dupé J, Chu W, Craig S, Borschmann R, O'Reilly G, Yates P, Melvin G, King K, Hiscock H. Adult Mental Health Presentations to Emergency Departments in Victoria, Australia between January 2018 and October 2020: Changes Associated with COVID-19 Pandemic Public Health Restrictions. Psychiatr Q 2024; 95:33-52. [PMID: 37938493 PMCID: PMC10901934 DOI: 10.1007/s11126-023-10057-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/09/2023]
Abstract
The COVID-19 pandemic and associated public health measures altered patterns of help-seeking for mental health, with increases in emergency department utilisation reported. We examined the association between COVID-19 restrictions and adult emergency department (ED) mental health presentations in Victoria, Australia, through secondary analysis of data from 39 public EDs across the state. Participants were all patients (18+ years) presenting between 1 January 2018 and 31 October 2020 with mental health or intentional self-harm. The main outcome was number of presentations for each mental health condition, by patient age, socioeconomic status (SES), location, and ED triage category. We used a Poisson regression model to compare predicted monthly ED presentations based on trends from 2018, 2019 and 2020 (up to 31 March), with observed presentations during the initial months of the COVID-19 pandemic (1 April to 31 October 2020). There was an average of 4,967 adult mental health presentations per month pre-COVID-19 (1 January-31 March 2020) and 5,054 per month during the COVID-19 period (1 April-31 October 2020). Compared to predicted incidence, eating disorder presentations increased 24.0% in the COVID-19 period, primarily among higher SES females aged 18-24 years. Developmental/behavioural disorder presentations decreased by 19.7% for all age groups. Pandemic restrictions were associated with overall increases in monthly adult ED presentations for mental health, with some disorders increasing and others decreasing. Accessibility of acute mental health services needs to be addressed to meet changing demand and ensure services are responsive to changes in presentations resulting from future public health challenges.
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Affiliation(s)
- Jackson Newberry-Dupé
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, Melbourne, VIC, 3052, Australia.
| | - Wanyu Chu
- Centre for Health Services, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Simon Craig
- Paediatric Emergency Department, Monash Medical Centre, Emergency Service, Monash Health, Clayton, VIC, Australia
- Department of Paediatrics, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
- Emergency Research Group, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Rohan Borschmann
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, Melbourne, VIC, 3052, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX, UK
| | - Gerard O'Reilly
- Emergency and Trauma Centre, The Alfred, Melbourne, Australia
- National Trauma Research Institute, The Alfred, Melbourne, Australia
- School of Public Health and Preventive Medicine, Alfred Campus, Monash University, Melbourne, Australia
| | - Paul Yates
- Department of Geriatric Medicine, Continuing Care Clinical Service Unit, Austin Health, Heidelberg, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Glenn Melvin
- School of Psychology, Deakin University, Melbourne, VIC, Australia
| | - Kylie King
- Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia
| | - Harriet Hiscock
- Centre for Health Services, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia
- Centre for Community Child Health, Royal Children's Hospital, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
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