AUTHOR=Pikkel Igal Yael , Meretyk Irit , Darawshe Aziz , Hayek Samer , Givon Limor , Levy Avi , Sipori Idan , Nuriel Yonatan , Bloch Boaz , Buniak Shraga , Eshel Ron , Fruchter Eyal 

TITLE=Trends in Psychiatric Emergency Department Visits in Northern Israel During the COVID-19 Outbreak

JOURNAL=Frontiers in Psychiatry

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.603318

DOI=10.3389/fpsyt.2021.603318

ISSN=1664-0640

ABSTRACT=<p><bold>Background:</bold> During the spread of coronavirus disease (COVID-19), mandatory quarantines increased social isolation and anxiety, with inevitable consequences on mental health and health seeking behavior. We wished to estimate those trends.</p><p><bold>Methods:</bold> We examined all psychiatric visits to the emergency department (ED) during March, April 2020, compared to identical months in 2018, 2019. We evaluated both number and nature of referrals.</p><p><bold>Results:</bold> Throughout the years, psychiatric referrals comprised about 5% of the total number of ED visits. In March-April 2020, 30% decreases were observed in overall ED visits and in psychiatric referrals in the ED. Compared to 2018–2019, in 2020, the proportions of these diagnoses were higher: anxiety disorders (14.5 vs. 5.4%, <italic>p</italic> &lt; 0.001), personality disorders (6.7 vs. 3.2%, <italic>p</italic> = 0.001), psychosis (9.5 vs. 6.7%, <italic>p</italic> = 0.049), post-traumatic stress disorder (3.2 vs. 1.5%, <italic>p</italic> = 0.023). Compared to 2018–2019, in 2020, proportions were lower for adjustment disorder (5.8 vs. 8.9%, <italic>p</italic> = 0.036) and for consultation regarding observation (11.7 vs. 31.6%, <italic>p</italic> &lt; 0.001). Differences were not observed between 2018-2019 and 2020 in the proportions of other diagnoses including suicide and self-harm disorders. Referrals concerning suicide and self-harm in a rural hospital and community clinic were 30% lower in the COVID-19 lockdown than in the same months in 2018, 2019.</p><p><bold>Conclusion:</bold> Psychiatric ED visits decreased by the same proportion as overall visits to the ED, apparently driven by fears of COVID-19. Referrals relating suicidality and self-harm shown nominal decrease, but their proportioned share remained constant. Increased anxiety and delayed care may eventually lead to increased mental health needs.</p>