Use of Acute Mental Health Care in U.S. Children’s Hospitals Before and After Statewide COVID-19 School Closure Orders
dc.contributor.author | Zima, Bonnie T. | |
dc.contributor.author | Edgcomb, Juliet Beni | |
dc.contributor.author | Rodean, Jonathan | |
dc.contributor.author | Cochran, Susan D. | |
dc.contributor.author | Harle, Christopher A. | |
dc.contributor.author | Pathak, Jyotishman | |
dc.contributor.author | Tseng, Chi-hong | |
dc.contributor.author | Bussing, Regina | |
dc.contributor.department | Health Policy and Management, Richard M. Fairbanks School of Public Health | |
dc.date.accessioned | 2025-04-04T08:05:39Z | |
dc.date.available | 2025-04-04T08:05:39Z | |
dc.date.issued | 2022 | |
dc.description.abstract | Objective: This study aimed to examine changes in child emergency department (ED) discharges and hospitalizations for primary general medical (GM) and primary psychiatric disorders; prevalence of psychiatric disorders among acute care encounters; and change in acute mental health (MH) care encounters by disorder type and, within these categories, by child sociodemographic characteristics before and after statewide COVID-19–related school closure orders. Methods: This retrospective, cross-sectional cohort study used the Pediatric Health Information System database to assess percent changes in ED discharges and hospitalizations (N=2,658,474 total encounters) among children ages 3–17 years in 44 U.S. children’s hospitals in 2020 compared with 2019, by using matched data for 36- and 12-calendar-week intervals. Results: Decline in MH ED discharges accounted for about half of the decline in ED discharges and hospitalizations for primary GM disorders (−24.8% vs. −49.1%), and MH hospitalizations declined 3.4 times less (−8.0% vs. −26.8%) in 2020. Suicide attempt or self-injury and depressive disorders accounted for >50% of acute MH care encounters before and after the statewide school closures. The increase in both ED discharges and hospitalizations for suicide attempt or self-injury was 5.1 percentage points (p<0.001). By fall 2020, MH hospitalizations for suicide attempt or self-injury rose by 41.7%, with a 43.8% and 49.2% rise among adolescents and girls, respectively. Conclusions: Suicide or self-injury and depressive disorders drove acute MH care encounters in 44 U.S. children’s hospitals after COVID-19–related school closures. Research is needed to identify continuing risk indicators (e.g., sociodemographic characteristics, psychiatric disorder types, and social determinants of health) of acute child MH care. | |
dc.eprint.version | Author's manuscript | |
dc.identifier.citation | Zima BT, Edgcomb JB, Rodean J, et al. Use of Acute Mental Health Care in U.S. Children's Hospitals Before and After Statewide COVID-19 School Closure Orders. Psychiatr Serv. 2022;73(11):1202-1209. doi:10.1176/appi.ps.202100582 | |
dc.identifier.uri | https://hdl.handle.net/1805/46820 | |
dc.language.iso | en_US | |
dc.publisher | American Psychiatric Association | |
dc.relation.isversionof | 10.1176/appi.ps.202100582 | |
dc.relation.journal | Psychiatric Services | |
dc.rights | Publisher Policy | |
dc.source | PMC | |
dc.subject | Adolescent suicide | |
dc.subject | Child mental health | |
dc.subject | Emergency psychiatry | |
dc.subject | Hospitalization | |
dc.title | Use of Acute Mental Health Care in U.S. Children’s Hospitals Before and After Statewide COVID-19 School Closure Orders | |
dc.type | Article |