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. 2023 May;59(4):622-630.
doi: 10.1007/s10597-022-01043-4. Epub 2022 Dec 12.

Psychiatric Emergencies in Los Angeles County During, and After, Initial COVID-19 Societal Restrictions: An Interrupted Time-Series Analysis

Tim A Bruckner  1 , Shutong Huo  2 , Michael Huynh  2 , Senxi Du  3 , Andrew Young  4 , Annie Ro  2
Affiliations

Psychiatric Emergencies in Los Angeles County During, and After, Initial COVID-19 Societal Restrictions: An Interrupted Time-Series Analysis

Tim A Bruckner et al. Community Ment Health J. 2023 May.

Abstract

Emergency department (ED) visits for psychiatric care in the US reportedly declined during the COVID-19 pandemic. This work, however, does not control for strong temporal patterning in visits before the pandemic and does not examine a potential "rebound" in demand for psychiatric care following the relaxation of initial societal restrictions. Here, we examine COVID-19-related perturbations in psychiatric care during and after the 1st stage of societal restrictions in the largest safety-net hospital in Los Angeles. We retrieved psychiatric ED visit data (98,888 total over 156 weeks, Jan 2018 to Dec 2020) from Los Angeles County + USC Medical Center. We applied interrupted time series methods to identify and control for autocorrelation in psychiatric ED visits before examining their relation with the 1st stage of societal restrictions (i.e., March 13 to May 8, 2020), as well as the subsequent "rebound" period of relaxed restrictions (i.e., after May 8, 2020). Psychiatric ED visits fell by 78.13 per week (i.e., 12%) during the 1st stage of societal restrictions (SD = 23.99, p < 0.01). Reductions in ED visits for alcohol use, substance use, and (to a lesser extent) anxiety disorders accounted for the overall decline. After the 1st stage of societal restrictions, however, we observe no "rebound" above expected values in psychiatric ED visits overall (coef = - 16.89, SD = 20.58, p = 0.41) or by diagnostic subtype. This pattern of results does not support speculation that, at the population level, foregoing ED care during initial societal restrictions subsequently induced a psychiatric "pandemic" of urgent visits.

Keywords: COVID-19 pandemic; Mental health services; Psychiatric emergency room visits; Societal restrictions.

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Conflict of interest statement

The authors have no competing interests to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
Count of Psychiatric Emergencies in LAC + USC Hospital over 156 weeks from Jan 5, 2018 to Dec 31, 2020. Note Initial set of societal restrictions (March 13 to May 8, 2020) shown with the blue dashed vertical lines. The left vertical line is at week 115 beginning on March 13, 2020 with 596 psychiatric emergency visits. The right vertical line is at week 123 beginning on May 8, 2020
Fig. 2
Fig. 2
Proportion of ED visits classified as psychiatric in LAC + USC hospital over 156 weeks from Jan 5, 2018 to Dec 31, 2020. Initial set of societal restrictions (March 13 to May 8, 2020) shown with the blue dashed vertical lines
Fig. 3
Fig. 3
Counts of Psychiatric Emergencies by Subtype in LAC + USC Hospital over 156 weeks from Jan 5, 2018 to Dec 31, 2020
See this image and copyright information in PMC

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