Impact of COVID-19 Pandemic on Outpatient Child and Adolescent Mental Health Service at a Tertiary Care Hospital of Pakistan

Abstract

Objective: to determine the impact of COVID-19 on mental health care service provision and the pattern of morbidity presenting to out-patient child psychiatry services in Pakistan.
 Study Design: Cross-sectional study.
 Place and Duration of Study: Child and Adolescent Mental Health Unit, Institute of Psychiatry, Rawalpindi Pakistan, Medical university, from Jan 2019 to Dec 2020.
 Methodology: Hospital records for the years 2019 and 2020 were used to get data on the total number of Out-Patient Department (OPD) visits in both years, and Departmental OPD records were used to extract data on all new patients.
 Results: Two thousand two hundred thirty-two OPD visits were recorded in 2019 versus 536 in 2020, a 76% decline. Eight hundred fifty-six new patients were seen in 2019 vs 259 in 2020. The detailed OPD record analysis revealed that the predominant age group reporting was adolescents in both years. 377(44%) patients reported with behavioural problems in 2019 vs 138(53.3%) in 2019. Pharmacological management plans were used in 138(16.1%) in 2019 vs 66(25.5%) in 2019. Common Diagnoses seen in both years were not significantly different, (p=0.087). OPD records were found to have an increase in the “not mentioned category”, thus reflecting declined quality of record keeping.
 Conclusion: The COVID-19-related lockdown and pandemic led to a sharp decline in out-patient visits and deterioration and record-keeping quality. The number of children and adolescents presenting with behavioural problems increased, but the common diagnoses remained similar.Keywords: COVID-19, Child and adolescent mental health service, Child psychiatry, Pandemic, School closure.