Abstract
BackgroundThe ‘lockdown’ measures, adopted to restrict population movements in order to help curb the novel coronavirus disease 2019 (COVID-19) pandemic, contributed to a global mental health crisis. Although several studies have extensively examined the impact of lockdown measures on the psychological well-being of the general population, little is known about long-term implications. This study aimed to identify changes in psychiatric emergency department (ED) admissions between two 8-week periods: during and immediately after lifting the lockdown.MethodsSocio-demographic and clinical information on 1477 psychiatric ED consultations at the University Hospital of Geneva (HUG) were retrospectively analyzed.ResultsWhen grouped according to admission dates, contrary to what we expected, the post-lockdown group presented with more severe clinical conditions (as measured using an urgency degree index) compared to their lockdown counterparts. Notably, after the lockdown had been lifted we observed a statistically significant increase in suicidal behavior and psychomotor agitation and a decrease in behavior disorder diagnoses. Furthermore, more migrants arrived at the HUG ED after the lockdown measures had been lifted. Logistic regression analysis identified diagnoses of suicidal behavior, behavioral disorders, psychomotor agitation, migrant status, involuntary admission, and private resident discharge as predictors of post-lockdown admissions.ConclusionsCollectively, these findings can have implications concerning the prioritization of mental health care facilities and access for patients at risk of psychopathological decompensation in time of confinement policies, but above all, provide a foundation for future studies focusing on the long-term impact of the pandemic and its associated sanitary measures on mental health.Trial registrationResearch Ethics Committee of Geneva, Registration number 2020–01510, approval date: 29 June 2020.
Highlights
The ‘lockdown’ measures, adopted to restrict population movements in order to help curb the novel coronavirus disease 2019 (COVID-19) pandemic, contributed to a global mental health crisis
For “suicidal behavior”, we only considered recent suicidal behavior, i.e., occurring in association with the current presentation at the psychiatric emergency department (ED)
It should be noted that by “migrant” we mean a person who arrived in Switzerland from a very low-income country, often as a refugee or asylum seeker, i.e., they do not have a residence permit but only possess “migrant status” which means that they must live in special residences that are subsidized by the Swiss state
Summary
The ‘lockdown’ measures, adopted to restrict population movements in order to help curb the novel coronavirus disease 2019 (COVID-19) pandemic, contributed to a global mental health crisis. Following the first case of SARS-CoV2 infection in Switzerland on February 25, 2020 [19], multiple clusters of infections were confirmed throughout the country [20], triggering the Federal Council to progressively adopt sanitary measures, including movement restrictions, the prohibition of large gatherings, and the mandatory closure of schools, stores, restaurants, and entertainment venues [21]. These lockdown-like measures were gradually relaxed in mid-May 2020 as the epidemiological situation improved in Switzerland
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