Impact of the COVID-19 Pandemic on Psychiatric Admissions to a Large Swiss Emergency Department: An Observational Study.

Julia Ambrosetti,Aline Folliet,François Sarasin,Paco Prada,Andrea Aguglia,Guido Bondolfi,Stefan Kaiser,Alexandre Wullschleger,Andrea Amerio,Alessandra Costanza,Gianluca Serafini,Laura Macheret

doi:10.3390/ijerph18031174

Abstract

The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency with profound mental health consequences. The psychiatric emergency department (ED) plays a key role during this mental health crisis. This study aimed to investigate differences in admissions at a Swiss psychiatric ED from 1 April to 15 May during a “pandemic-free” period in 2016 and a “during-pandemic” period in 2020. The study included 579 consultations at psychiatric ED in the “during-pandemic” period and 702 in the “pandemic-free” period. Sociodemographic and clinical characteristics were compared, and logistic regression analysis was performed to identify variables associated with psychiatric admissions during the pandemic. A reduction in total psychiatric ED admissions was documented during COVID-19. Logistic regression analysis predicted the independent variable (ED admission during the pandemic) and estimated odds ratio (OR) for being unmarried/not in a relationship, arrival in an ambulance, suicidal behavior, behavioral disorders and psychomotor agitation. Though only statistically significant in bivariate analysis, patients were also more likely to be involuntarily hospitalized. This picture appears to be reversed from a sociodemographic and clinical point of view to our observation of psychiatric ED consultation in 2016. These findings highlight that the reduction in psychiatric ED admissions during the pandemic seems to be associated with living alone and more severe psychopathologies, which must alert psychiatrists to ensure access to mental health care in times of pandemic.

Highlights

The World Health Organization declared the novel coronavirus disease 2019 (COVID-19)outbreak a Public Health Emergency of International Concern and a pandemic [1].The first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was announced in the canton of Geneva on 26 February [2]
The research project may be validly considered to be in a higher interest than the interests of the persons concerned when it can be expected to lead to the acquisition of knowledge that will benefit future patients or that could not otherwise be acquired
Patients admitted to the psychiatric emergency department (ED) during the COVID-19 pandemic were more frequently unmarried/not in a relationship and separated/divorced (p < 0.001), were less likely to be self-referred, arrived more often by ambulance (p < 0.001), were more frequently admitted overnight (p = 0.005), had a more severe degree of emergency according to the

Summary

Introduction

The World Health Organization declared the novel coronavirus disease 2019 (COVID-19)outbreak a Public Health Emergency of International Concern and a pandemic [1].The first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was announced in the canton of Geneva on 26 February [2]. Council adopted severe public policies to restrict population movement and curb disease spread, including banning groups of more than 100 people, closing schools and universities, and introducing initial border controls with neighboring countries [2]. The situation was qualified to be “extraordinary” by the Federal Council on 16 March, which banned any public or private events and ordered closures of stores, restaurants, public leisure activity facilities, and entertainment venues, with only grocery stores, post offices, banks, and pharmacies remaining open. The population was asked to stay at home, and, unlike some other European countries, no strict lockdown with stay at home orders was established [2]. These restrictive measures were progressively attenuated from 27 April onwards

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