The study finds that assessing changes in the rate of hospitalizations for mental health conditions among adolescents is critical to ensuring prioritization of public health programs that address psychiatric health care needs that have emerged during the COVID-19 pandemic.
During the COVID-19 pandemic, various studies have documented increases in depression, anxiety and suicidal tendencies among adolescents. This increase was associated, at least in part, with large disruptions caused by social distancing measures that impacted routine educational and leisure activities and limited social interactions with peers.
Adolescents with serious mental health conditions may require hospitalization if they are at risk of self-harm and cannot be safely maintained at home. A recent study sought to determine whether the pandemic caused an increase in the monthly hospitalization rate associated with mental health conditions among adolescents.
“Assessing changes in the rate of hospitalizations for mental health conditions among adolescents is critical to ensuring prioritization of public health programs targeting psychiatric health care needs that have emerged during the pandemic,” the study authors wrote. “There is also a need to better understand the health infrastructure and resources required to deliver high-quality mental health care to these patients.”
The authors designed a cohort study by drawing data from a sample of sites participating in the Consortium for Clinical Characterization of COVID-19 (4CE). Participants ranged in age from 11 to 17 years and had had a hospitalization associated with at least 1 diagnosis of a mental health condition between February 1, 2019 and April 30, 2021. In total, data were from 8 children’s hospitals , 5 from the United States and 3 from France.
To examine changes in the proportions of hospitalizations, the authors indicated a prepandemic period from February 1, 2019 to March 31, 2020 and a pandemic period from April 1, 2020 to April 30, 2021. Inclusion criteria included 9696 adolescents who had at least 1 hospitalization hospitalization associated with mental health conditions during the prepandemic period and 11,101 during the pandemic period.
At admission, the mean age was 14.6 years in the prepandemic cohort and 14.7 years in the pandemic cohort. Furthermore, there was a higher proportion of females than males hospitalized in both periods (5966 [61.5% vs 3730 [38.5%]; P <.001) (7603 [68.5%] against 3498 [31.5%]; P <.001) in the prepandemic and pandemic group, respectively. Specifically, the 3 most prevalent mental health conditions in the study population were anxiety, depression, and suicide or self-harm.
“Our findings are consistent with previous studies, highlighting the potential association of pandemic-related disruptions with adolescents’ social, emotional, and behavioral well-being,” the study authors wrote. “The increased disease burden observed among female adolescents is also in line with findings reported in other analyses.”
Overall, the study found that in the prepandemic period, hospitals reported 36,059 total hospitalizations, of which 12,122 (33.6%) were related to mental health. Comparatively, during the pandemic period, 11,605 of 31,908 (36.4%) of hospitalizations were related to mental health. This significant increase (0.60% [95% CI. 0.31%-0.89%]) was found in 4 out of 5 hospitals in the United States and 1 out of 3 in France.
“We observed high rates of hospitalizations associated with anxiety, depression, and suicide or self-harm during the pandemic…these findings support the need for continued resource prioritization for children’s hospitals to provide care for adolescents with mental health conditions” , the study authors wrote.
References
Gutierrez-Sacristan A, Serret-Larmande A, Hutch M, et al. Hospitalizations associated with mental health conditions among adolescents in the United States and France during the COVID-19 pandemic. JAMA network open. 2022;5(12):e2246548. doi:10.1001/jamannetworkopen.2022.46548