(O-G5) Effect of the COVID-19 Pandemic on Adult Emergency Department (ED) Visits for Depression and Suicidal Ideation

Objectives: We hypothesized that the changes following COVID-19 would cause an increase in ED visits for depression and suicidal ideation/self-harm (DS).

Background: In March 2020, the COVID-19 pandemic reached the New York tri-state area, which, at the time, was one of the regions in the United States that the virus most severely affected. Social isolation increased due to mandates and fear of exposure to the virus. Quarantining at home, fear of becoming sick, and job disruptions caused the level of stress in the population to increase. We hypothesized this would cause an increase in ED visits for depression and suicidal ideation/self-harm (DS). Our goal was to determine whether the ED visits for DS in adult patients changed after the arrival of COVID-19.

Methods:

Design: Retrospective cohort. Setting: EDs of 8 hospitals within 150 miles of New York City. Hospitals were teaching and non-teaching in rural, suburban and urban areas. Total annual ED volumes ranged from 30,000 to 120,000. Population: Consecutive ED patients > 21 years old from March 1 to November 30 in 2019 through 2022. (March 2020 was the start of the pandemic and our database ended on November 30th for each year.) Data analysis: We tallied the number of patients in each year with DS, identified using International Classification of Disease codes (version 10). We calculated the proportion of these visits to total ED visits for patients ages > 21 years in 2019 through 2022 to account for the marked decrease in total ED visits after the start of the pandemic. We report the changes in these proportions from 2019 to 2020, 2021 and 2022, along with 95% confidence intervals (CIs).

Results: Total adult ED visits for patients > 21 years old from Mar-Nov of each year were: 374,965, 279,977, 271,126 and 284,113 in the years 2019 – 2022, respectively. The numbers of DS from Mar-Nov of each year were: 3531, 2825, 2175, and 1935 in the years 2019 – 2022, respectively. The percent changes in the proportions of visits for DS from 2019 (with 95% CIs) were: 2020: +7% (2% to 13%), 2021: -15% (-10% to -19%), and 2022: -28% (-24% to -32%).

Conclusions: Consistent with our hypothesis, the proportion of ED visits for depression and self-harm/suicidal ideation, increased in the year following the arrival of COVID-19, but unexpectedly decreased in 2021 and 2022. The reasons for these decreases are unclear.

References (Optional):

Funding (Optional): None.