Top 5 Takeaways

1. Increase in Adolescent Female Visits: Weekly ED visits among adolescent females for mental health conditions increased significantly during the pandemic, particularly for eating and tic disorders.
2. Proportion of Visits: The proportion of ED visits for mental health conditions among children and adolescents increased during the pandemic compared to 2019.
3. Specific Mental Health Conditions: Visits for specific mental health conditions like depression, anxiety, and obsessive-compulsive disorder increased among adolescent females during 2021 and January 2022.
4. Public Health Implications: Early identification and expanded prevention and intervention strategies are crucial for improving pediatric mental health, especially among adolescent females.
5. Impact of the Pandemic: The COVID-19 pandemic exacerbated mental health issues among children and adolescents, with significant increases in distress and related ED visits.

Original Article Author and Citation

Corresponding Author

Lakshmi Radhakrishnan, LRadhakrishnan@cdc.gov

Suggested Citation

Radhakrishnan L, Leeb RT, Bitsko RH, et al. Pediatric Emergency Department Visits Associated with Mental Health Conditions Before and During the COVID-19 Pandemic — United States, January 2019–January 2022. MMWR Morb Mortal Wkly Rep 2022;71:319–324. DOI: http://dx.doi.org/10.15585/mmwr.mm7108e2

Summary

This report examines the changes in pediatric emergency department (ED) visits for mental health conditions (MHCs) before and during the COVID-19 pandemic. The study found that the proportion of ED visits for MHCs increased during the pandemic, with significant increases among adolescent females for conditions such as eating and tic disorders. The findings highlight the need for early identification and expanded prevention and intervention strategies to address the mental health needs of children and adolescents, particularly adolescent females.

Methods

Data from the National Syndromic Surveillance Program (NSSP) were analyzed for three pandemic surveillance periods: March 15, 2020–January 2, 2021; January 3, 2021–January 1, 2022; and January 2, 2022–January 29, 2022. These periods were compared with corresponding weeks in 2019. The study calculated the percent change in mean number of weekly ED visits for children and adolescents aged 0–17 years, by age group and sex. Visit ratios (VRs) with 95% confidence intervals (CIs) were also calculated.

Discussion

The study found that weekly ED visits for MHCs among children and adolescents decreased during 2020 but varied by age and sex during 2021 and January 2022. Adolescent females aged 12–17 years showed significant increases in visits for specific MHCs, including eating and tic disorders, depression, anxiety, and obsessive-compulsive disorder. The pandemic’s impact on mental health was particularly high among adolescent girls, possibly due to increased distress, reduced access to mental health care, and exposure to adverse childhood experiences.

Conclusion

Implementing evidence-based primary prevention, early identification, and intervention strategies is critical to improving pediatric mental health. The findings underscore the need for policies to improve access to mental health services and community-based prevention strategies to mitigate the risk for MHCs among children and adolescents.

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