scholarly journals Impact of Pandemics/Epidemics on Emergency Department Utilization for Mental Health and Substance Use: A Rapid Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Julie Munich ◽  
Liz Dennett ◽  
Jennifer Swainson ◽  
Andrew J. Greenshaw ◽  
Jake Hayward
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Substance Use ◽  
Global Mental Health ◽  
System Level ◽  
Rapid Review ◽  
Emergency Department Utilization ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
The Impact

Background: A prolonged COVID-19 pandemic has the potential to trigger a global mental health crisis increasing demand for mental health emergency services. We undertook a rapid review of the impact of pandemics and epidemics on emergency department utilization for mental health (MH) and substance use (SU).Objective: To rapidly synthesize available data on emergency department utilization for psychiatric concerns during COVID-19.Methods: An information specialist searched Medline, Embase, Psycinfo, CINAHL, and Scopus on June 16, 2020 and updated the search on July 24, 2020. Our search identified 803 abstracts, 7 of which were included in the review. Six articles reported on the COVID-19 pandemic and one on the SARS epidemic.Results: All studies reported a decrease in overall and MH related ED utilization during the early pandemic/epidemic. Two studies found an increase in SU related visits during the same period. No data were available for mid and late stage pandemics and the definitions for MH and SU related visits were inconsistent across studies.Conclusions: Our results suggest that COVID-19 has resulted in an initial decrease in ED visits for MH and an increase in visits for SU. Given the relative paucity of data on the subject and inconsistent analytic methods used in existing studies, there is an urgent need for investigation of pandemic-related changes in ED case-mix to inform system-level change as the pandemic continues.

Impact of COVID-19 on Emergency Utilization for Mental Health and Substance Use: A Rapid Review (Preprint)

2020 ◽  
Author(s):  
Julie Munich ◽  
Elizabeth Dennett ◽  
Jennifer Swainson ◽  
Andrew Greenshaw ◽  
Jake Hayward
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Substance Use ◽  
Global Mental Health ◽  
System Level ◽  
Rapid Review ◽  
Emergency Department Utilization ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
The Impact

BACKGROUND A prolonged COVID-19 pandemic has the potential to trigger a global mental health crisis increasing demand for mental health emergency services. We undertook a rapid review of the impact of pandemics and epidemics on emergency department utilization for mental health (MH) and substance use (SU). OBJECTIVE To rapidly synthesize available data on emergency department utilization for psychiatric concerns during COVID-19. METHODS An information specialist searched Medline, Embase, Psycinfo, CINAHL, and Scopus on June 16, 2020 and updated the search on July 24, 2020. Our search identified 803 abstracts, 7 of which were included in the review. Six articles reported on the COVID-19 pandemic and one on the SARS epidemic. RESULTS All studies reported a decrease in overall and MH related ED utilization during the early pandemic/epidemic. Two studies found an increase in SU related visits during the same period. No data were available for mid and late stage pandemics and the definitions for MH and SU related visits were inconsistent across studies. CONCLUSIONS Our results suggest that COVID-19 has resulted in an initial decrease in ED visits for MH and an increase in visits for SU. Given the relative paucity of data on the subject and inconsistent analytic methods used in existing studies, there is an urgent need for investigation of pandemic-related changes in ED case-mix to inform system-level change as the pandemic continues. CLINICALTRIAL None

scholarly journals Subjective Experiences of Mental Health Crisis Care in Emergency Departments: A Narrative Review of the Qualitative Literature

2021 ◽  
Vol 18 (18) ◽  
pp. 9650
Author(s):  
Helena Roennfeldt ◽  
Marianne Wyder ◽  
Louise Byrne ◽  
Nicole Hill ◽  
Rory Randall ◽  
...  
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Subjective Experience ◽  
Initial Contact ◽  
Mental Health Crisis ◽  
Subjective Experiences ◽  
Health Crisis ◽  
Negative Experiences ◽  
The Impact ◽  
Qualitative Literature

Mental health presentations to the emergency department (ED) have increased, and the emergency department has become the initial contact point for people in a mental health crisis. However, there is mounting evidence that the ED is not appropriate nor effective in responding to people in mental health crises. Insufficient attention has been paid to the subjective experience of people seeking support during a mental health crisis. This review aims to describe the qualitative literature involving the subjective experiences of people presenting to the ED during a mental health crisis. The method was guided by Arksey and O’Malley’s framework for scoping studies and included keyword searches of PsycINFO, CINAHL, Medline and Embase. A narrative analysis, drawing on the visual tool of journey mapping, was applied to summarise the findings. Twenty-three studies were included. The findings represent the experience of accessing EDs, through to the impact of treatment. The review found points of opportunity that improve people’s experiences and characteristics associated with negative experiences. The findings highlight the predominance and impact of negative experiences of the ED and the incongruence between the expectations of people presenting to the ED and the experience of treatment.

scholarly journals Impact of the COVID-19 pandemic on suicide and self-harm among patients presenting to the emergency department of a teaching hospital in Nepal

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250706
Author(s):  
Roshana Shrestha ◽  
Shisir Siwakoti ◽  
Saumya Singh ◽  
Anmol Purna Shrestha
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Significant Degree ◽  
Organophosphate Poisoning ◽  
Mental Health Crisis ◽  
Record System ◽  
Cross Sectional ◽  
Health Crisis ◽  
Self Harm ◽  
The Impact

The COVID-19 pandemic is a global challenge that is not just limited to the physical consequences but also a significant degree of a mental health crisis. Self-harm and suicide are its extreme effects. We aim to explore the impact of this pandemic on suicide and self-harm in our Emergency Department. A cross-sectional study was conducted including all fatal and nonfatal self-harm patients presenting to the emergency department during the lockdown period (March 24-June 23, 2020; Period1), matching periods in the previous year (March 24-June 23,2019; Period 2) and 3 months period prior (December 24 2019-March 23, 2020; Period 3) were included through the electronic medical record system. The prevalence and the clinical profile were compared between these three periods. A total of 125 (periods 1 = 55, 2 = 38, and 3 = 32) suicide and self-harm cases were analyzed. Suicide and self-harm had increased by 44% and 71.9% during the lockdown in comparison to periods 2 and 3. Organophosphate poisoning was the most common mode. Females were predominant in all three periods with a mean age of 32 (95%CI: 29.3–34.7). There was a significant delay in arrival of the patients in period 1 (p = 0.045) with increased hospital admission (p = 0.003) and in-hospital mortality (18.2% vs 2.6% and 3.1%) (p<0.001). Our study showed an increase in suicide and self-harm cases in the emergency department during the initial phase of the COVID-19 pandemic which may reflect the increased mental health crisis in the community in low resource settings like Nepal. This study highlights the importance of priming all mental health care stakeholders to initiate mental health screening and intervention for the vulnerable population during this period of crisis.

The Crisis and Transition Services (CATS) Model: A Program to Divert Youths in Mental Health Crisis From the Emergency Department

2020 ◽  
Vol 71 (11) ◽  
pp. 1203-1206
Author(s):  
Amanda Ribbers ◽  
David Sheridan ◽  
Ajit Jetmalani ◽  
Julie Magers ◽  
Amber Laurie Lin ◽  
...  
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Transition Services ◽  
Mental Health Crisis ◽  
Health Crisis

scholarly journals Psychiatric liaison referrals: a thematic analysis during peak COVID-19

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S294-S294
Author(s):  
Kaj Svedberg ◽  
William Hancox ◽  
Hugh Grant-Peterkin
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Careful Consideration ◽  
University Hospital ◽  
Medical Attention ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Low Mood ◽  
Crisis Care

AimsWith the advent of the COVID-19 Pandemic the NHS long term Plan commitments of January 2019 to improve crisis care nationwide became all the more pressing. The aim of this study was to thematically investigate what mental health crisis presentations might be diverted from the Emergency department to external crisis hubs in order to reduce the COVID-19 contamination risks.MethodAll referrals made to the Homerton University Hospital (HUH) mental health liaison service were looked at between 1/3/20-11/6/20 (n = 846), coinciding with the first peak of the COVID-19 Pandemic.Referral data was anonymised and sorted independently into naturally emerging thematic classes by two junior liaison doctors.Cases that did not clearly fit any of the 14 themes generated were further looked into to determine outcome of referral and discussed to try and match to an appropriate class.Result14 frequent themes for mental health crisis referrals were identified. The distribution of these ranged from most common (suicidality) to neurocognitive presentation and identified shifts in themes over the course of the pandemic peak such as increases of low mood, anxiety and intoxication requiring medical attention over the three month period.ConclusionAlthough themes for presentations may be identified in acute referrals to mental health liaison services it is problematic determining how these may be parsed safely to crisis hubs without risking overlooking cases that may require medical attention. The most common theme that was identified and remained throughout the first wave of the COVID-19 Pandemic was acute suicidal presentation. The remaining themes would require careful consideration around risk thresholds for what a service may wish to accept in devolving the emergency department liaison and balance these against future risks of repeat COVID-19 waves.

scholarly journals Mental health problems in the general population during and after the first lockdown phase due to the SARS-Cov-2 pandemic: Rapid review of multi-wave studies

2020 ◽  
Author(s):  
Dirk Richter ◽  
Steffi Riedel-Heller ◽  
Simeon Zuercher
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Health Problems ◽  
Rapid Review ◽  
Care Utilization ◽  
Related Factors ◽  
Cross Sectional ◽  
Health Crisis ◽  
General Populations ◽  
The Impact

BackgroundThe SARS-Cov-2 pandemic and the lockdown response have increased mental health problems in general populations compared to pre-pandemic times. The course of mental health problems during and after the first lockdown phase has not yet been reviewed.MethodsWe conducted a rapid review of multi-wave studies in general populations with time points during and after the first lockdown phase. Repeated cross-sectional and longitudinal studies were included. The main outcome assessed was whether indicators of mental health problems have changed during and after the first lockdown phase. The study was registered with PROSPERO No. CRD42020218640Findings23 studies with 56 indicators were included in the qualitative review. Studies that reported data from pre-pandemic assessments through lockdown indicated an increase in mental health problems. During lockdown no uniform trend could be identified. After lockdown mental health problems decreased slightly.InterpretationAs mental health care utilization indicators and data on suicides do not suggest an increase in demand during the first lockdown phase, we regard the increase in mental health problems as general distress that is to be expected during a global health crisis. Several methodological, pandemic-related, response-related and health policy-related factors need to be considered when trying to gain a broader perspective on the impact of the first wave of the pandemic and the first phase of lockdown on general populations’ mental health.

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