Abstract
BackgroundThe COVID-19 pandemic and subsequent lockdown measures have led to increasing mental health concerns in the general population. We aimed to assess the short-term impact of the pandemic lockdown on mental health emergency services use in the Kitchener-Waterloo region of Ontario, Canada.MethodsWe conducted an observational study during the 6-month period between March 5 and September 5, 2020 using National Ambulatory Care Reporting System metadata from mental health visits to three regional Emergency Departments (ED); mental health and substance related police calls; and calls to a regional mental health crisis telephone line, comparing volumes during the pandemic lockdown with the same period in 2019. Quasi-Poisson regressions were used to determine significant differences between numbers of each visit or call type during the lockdown period versus the previous year. Significant changes in ED visits, mental health diagnoses, police responses, and calls to the crisis line from March 5 to September 5, 2020 were examined using changepoint analyses.ResultsInvoluntary admissions, substance related visits, mood related visits, situational crisis visits, and self-harm related mental health visits to the EDs were significantly reduced during the lockdown period compared to the year before. Psychosis-related and alcohol-related visits were not significantly reduced. Among police calls, suicide attempts were significantly decreased during the period of lockdown, but intoxication, assault, and domestic disputes were not significantly different. Mental health crisis telephone calls were significantly decreased during the lockdown period. There was a significant increase in weekly mental health diagnoses starting in the week of July 12 – July 18. There was a significant increase in crisis calls starting in the week of May 31 – June 6, the same week that many guidelines, such as gathering restrictions, were eased. There was a significant increase in weekly police responses starting in the week of June 14 – June 20.ConclusionsContrary to our hypothesis, the decrease in most types of mental health ED visits, mental health and substance-related police calls, and mental health crisis calls largely mirrored the overall decline in emergency services usage during the lockdown period. This finding is unexpected in the context of increased attention to acutely deteriorating mental health during the COVID-19 pandemic.
Highlights
During the COVID-19 pandemic, the scope of community containment measures have been unprecedented in modern history and are colloquially referred to as “lockdowns” [1]
Contrary to our hypothesis, the decrease in most types of mental health Emergency Departments (ED) visits, mental health and substance-related police calls, and mental health crisis calls largely mirrored the overall decline in emergency services usage during the lockdown period
This finding is unexpected in the context of increased attention to acutely deteriorating mental health during the COVID-19 pandemic
Summary
During the COVID-19 pandemic, the scope of community containment measures have been unprecedented in modern history and are colloquially referred to as “lockdowns” [1] Such measures are variably defined, but generally expand voluntary physical distancing measures through business, school, and workplace closures, restrictions on movement and social gatherings, and imposition of legal penalties for violations. Community lockdowns conflict with individual rights to movement and assembly, and may further isolate the marginalized, older adults, and those living alone. This may exacerbate loneliness and depression and contribute to mental health-related morbidity and mortality [9,10,11,12]. We aimed to assess the short-term impact of the pandemic lockdown on mental health emergency services use in the Kitchener-Waterloo region of Ontario, Canada
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