Abstract

The World Health Organization characterized COVID-19 (coronavirus disease 2019) as a pandemic on March 11, 2020 (WHO). Within a couple of days, all Canadian provinces announced the implementation of social distancing measures. We evaluated the immediate effect of COVID-19 on psychiatric emergency and inpatient services in Canada's largest psychiatric hospital in the first month of the pandemic. We extracted data from the electronic medical records of the Center for Addiction and Mental Health in Toronto, Canada. We compared emergency department visits, inpatient occupancy rates, and length of stay in March 2019 and March 2020, and during the first and second half of March 2020. There was a decrease in the number of emergency department visits and inpatient occupancy rates in March 2020 compared to March 2019. There was also a significant decrease in the number of emergency department visits and inpatient occupancy rates in the second half of March 2020 compared to the first half. Our findings suggest that the pandemic was followed by a rapid decrease in the usage of psychiatric emergency and inpatient services in a large mental health hospital. Future studies will need to assess whether this decrease will be followed by a return to baseline or an increase in need for these services.

Highlights

  • COVID-19 (Coronavirus disease 2019) is a disease caused by the severe acute respiratory syndrome (SARS)-CoV2 [1] virus identified in Wuhan, China in December 2019

  • Data from this study were extracted from electronic medical records (EMR) of the Center for Addiction and Mental Health (CAMH) emergency department (ED) and its 10 acute inpatient units: Acute Care Unit A (ACU A), Concurrent Addictions Inpatient Treatment Service (CAITS), Emergency Assessment Unit (EAU), Early Psychosis Unit (EPU), General Psychiatric Unit (GPU) A and B, Mood and Anxiety Inpatient Unit (MAUI), Medical Withdrawal Services (MWS), Psychiatric Intensive Care Unit (PICU), and Women’s Inpatient Unit (WIU)

  • Our study focused on the 2 weeks before and after the announcement of social distancing measures to allow for the examination of immediate changes produced by the implementation of these measures compared to the same time frame that would presumably have the same weather conditions and sociopolitical factors influencing service utilization

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Summary

Introduction

COVID-19 (Coronavirus disease 2019) is a disease caused by the SARS-CoV2 [1] virus identified in Wuhan, China in December 2019. It was declared a pandemic on March 11th. It has been speculated that social distancing associated with the current COVID-19 pandemic may both directly and indirectly increase the risk of suicide [17]. Together, these studies show that the potential impact of disasters on the need for, and use of, psychiatric services is complex

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