ADVERTISEMENT
Trends in ED Visits During Pandemic Highlight Limited Care Options for Mental Health Patients
Emergency department (ED) visits related to mental health decreased less than visits for other medical reasons during the COVID-19 pandemic, according to a study published this week by researchers from the University of California. The findings suggest that patients with mental health conditions may have less flexibility for receiving care during public health emergencies.
The cross-sectional study, published on JAMA Network Open, was based on administrative data from weekly ED visits and a subset of visits for mental health conditions at 10 Department of Health and Human Services (HHS) regions. Data for five 11-week periods was collected from the National Syndromic Surveillance Program from January 2019 to December 2021.
The study included 1570 total observations, and statistically significant changes in mental health-related and non-mental health ED visits were observed across all 10 HHS regions. In the 2 weeks after COVID-19 was declared a pandemic in March 2020, total ED visits decreased by 39% compared to the same weeks a year prior. Mental health-related visits, meanwhile, decreased by 23%. By 2021, total ED visits returned to levels higher than 2019.
The changes in frequency of how emergency departments were used during the study period have several implications, the Cal researchers said.
“First, the increased proportion of mental health-related ED visits may be interpreted as an increase in the underlying need for critical care mental health services,” the researchers wrote. “As suggested by the literature, patients with more severe illness tended to present to the ED during the pandemic, resulting in a larger proportion of higher-acuity and admitted visits compared with nonpandemic times.
“Further, this decrease in lower-acuity visits (eg, for sprains, strains, or chronic conditions) typically observed during nonpandemic times may have constrained the number of MH-related visits observed because of long ED wait times, resulting in an underestimate of critical MH needs before the pandemic.”
The researchers also concluded that, based on their findings, patients with non-mental health conditions may have a greater ability to adapt to public health emergencies, and that while those with non-mental health conditions may have flexibility to delay treatment or pursue alternative means of care, mental health patients may have fewer options.
“These findings highlight the importance of addressing the provision of adequate mental health services, both in acute and outpatient settings,” the researchers wrote.
Reference
