Maimonides Evening of Research
Fellow Winner
David Guernsey III, DO, MPH
The Impact of the COVID-19 Pandemic on Pediatric Mental Health: A Pediatric Emergency Department’s Perspective
Objectives
Pediatric mental health in the United States has become a public health crisis. Pediatric emergency departments (PED) encounter these patients during mental health emergencies. The COVID-19 pandemic disrupted the social environment of pediatric patients leading to a potential worsening of this crisis. This study examined the rate of mental health visits to PED prior to and during the COVID-19 pandemic.
Methods
This retrospective cohort study assessed the proportion of mental health visits at a single urban, PED between three time periods years: September 2019 to August 2020, September 2020-August 2021, and September 2021 to February 2022. Inclusion criteria were subjects aged 6 to 18 years with a holding order applied and one of the specific International Classification of Disease, Tenth Division (ICD-10) codes: F01-F99, T14.19, R45, R46.89. Proportion of mental health visits were compared between the two 12-month periods and in 6-month periods with the first 6-months representing the pre-COVID-19 pandemic. Secondary analysis compared demographic information and ICD-10 codes.
Results
A total of 1036 charts were studied: 126 charts from 2019-2020, 512 from 2020-2021, and 398 from 2021-2022. Proportion of mental health visits in 2019-2020 was 1.2% while 6.0% in 2020-2021 which was statistically significant (p < 0.001). In 6-month analysis, there was a statistically significance difference (p < 0.001) demonstrating a higher proportion of mental health visits after the COVID-19 pandemic. Secondary analysis demonstrated statistically higher proportion of females (p = 0.047) in 2019-2020 while a statistically higher proportion of private insurance in 2020-2021 (p < 0.001).
Conclusion And Implication
This study demonstrated a significant increase in pediatric mental health visits following the start of the COVID-19 pandemic. The pandemic produced stressors and traumatic experiences that negatively affected pediatric mental health an area already defined as a public health crisis. We anticipate this increase in visits will continue to worsen overburdened PED.