Abstract
The COVID-19 pandemic has caused societal restrictions and public fear which may have impacted the pattern of seeking psychiatric care. There has generally been a decrease in the numbers seeking acute psychiatric care. It is important to investigate which groups seeking psychiatric treatment have decreased in number. The aim of our investigation was to identify which groups have a changed pattern in acute psychiatric service utilization during the first two waves of the COVID-19 pandemic. The study investigated changes in the rate and pattern of visits and hospital admissions for psychiatric disorders at a large Swedish hospital. A register-based study was conducted using administrative data on adult psychiatric emergency department visits (PEVs) and hospital admission rates. Data during the first two COVID-19 waves were compared to corresponding control periods in 2018–2019. Furthermore, a survey was performed among patients visiting the Psychiatric Emergency Department on their views of COVID-19 and acute psychiatric care. During the COVID-19 periods, PEVs were reduced overall by 16 and 15% during the first and second wave, respectively (p < 0.001 in both cases), while the rate of admissions remained unaltered. PEVs were significantly reduced for most psychiatric diagnosis subgroups except for patients with schizophrenia and other related psychotic disorders as well as for those who required ongoing outpatient care. Most of the survey respondents disagreed that the pandemic affected their visit and about a quarter thought a video call with a doctor could have replaced their visit. In conclusion, there was a significant reduction in overall PEVs during both COVID-19 waves but this did not affect the numbers requiring admission for psychiatric inpatient care.
Highlights
In March 2020, the World Health Organization declared the COVID-19 disease as a global pandemic [1]
There was a similar pattern of significant psychiatric emergency department visits (PEVs) reductions among the different patient characteristic and diagnostic subgroups during the second COVID-19 wave as during the first wave, except for patients with bipolar and related mood disorders and patients with no diagnosis who did not show a significant reduction in PEVs during the second wave
A significant reduction in overall PEVs was found during the first and second COVID-19 waves, but there was no significant reduction in numbers of hospital admissions
Summary
In March 2020, the World Health Organization declared the COVID-19 disease as a global pandemic [1]. Various societal efforts such as social distancing and restrictions on mobility have been implemented worldwide to mitigate the spread of the COVID-19 virus. These measures along with other directly COVID-19-related factors. Acute Psychiatric Services During COVID-19 might be expected to influence those suffering from mental health issues during the ongoing pandemic and in a longer perspective [2]. It remains to be seen how much COVID-19 has impacted public mental health [3, 4] and, in particular, among persons with previous mental disorders [5]. In Sweden, the strategy has consisted of general recommendations of limited mobility (i.e., encouraging people not to travel) and social distancing in contrast to the full lockdown in many other European countries [7]
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