Inpatient Mental Healthcare before and during the COVID-19 Pandemic.

Alan B Mcguire,Jennifer M Garabrant,Emily Bass,Laura J Myers,Mindy E Flanagan,Angela L Rollins,Michelle P Salyers,Marina Kukla

doi:10.3390/healthcare9121613

Abstract

Prior studies have demonstrated disruption to outpatient mental health services after the onset of the COVID-19 pandemic. Inpatient mental health services have received less attention. The current study utilized an existing cohort of 33 Veterans Health Affairs (VHA) acute inpatient mental health units to examine disruptions to inpatient services. It further explored the association between patient demographic, clinical, and services variables on relapse rates. Inpatient admissions and therapeutic services (group and individual therapy and peer support) were lower amongst the COVID-19 sample than prior to the onset of COVID-19 while lengths of stay were longer. Relapse rates did not differ between cohorts. Patients with prior emergent services use as well as substance abuse or personality disorder diagnoses were at higher risk for relapse. Receiving group therapy while admitted was associated with lower risk of relapse. Inpatient mental health services saw substantial disruptions across the cohort. Inpatient mental health services, including group therapy, may be an important tool to prevent subsequent relapse.

Highlights

Holland and colleagues [4]) report emergency department (ED) visits related to mental illness, suicide, substance abuse and other mental health crises increased during the primary US surges from March to October
Data from the Veterans Affairs (VA) Corporate Data Warehouse (CDW) (The Department of Veterans Affairs (VA), Office of Information & Technology) were used to identify patients hospitalized on an acute mental health ward at one of the 33 VA facilities included in the original study
Admissions show a noticeable drop in April 2020 and again in November and December 2020, which correspond to peaks in COVID-19 infections rates in the United States

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. COVID-19 wreaked havoc on the healthcare system. Some emergency departments and intensive care units were flooded with patients [1] and early indicators predicted demand beyond hospital capacity [2] while other non-COVID-19 admissions fell dramatically [3]. Adult mental health services saw significant changes. Holland and colleagues [4]) report ED visits related to mental illness, suicide, substance abuse and other mental health crises increased during the primary US surges from March to October

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Results

Discussion

Conclusion