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. 2023 Mar 6;11(5):765.
doi: 10.3390/healthcare11050765.

Child and Adolescent Mental Health during the COVID-19 Pandemic: Challenges of Psychiatric Outpatient Clinics

Mariela Mosheva  1   2 , Yael Barzilai  3 , Nimrod Hertz-Palmor  1   4 , Ehud Mekori-Domachevsky  1   2 , Asia Avinir  1   2 , Galit Erez  3 , Noa Vardi  2   5 , Gila Schoen  2   5 , Tal Lahav  2   6 , Hadar Sadeh  7   8 , Michal Rapaport  2   9 , Chen Dror  2   3 , Alex Gizunterman  10 , Shlomit Tsafrir  11 , Doron Gothelf  1   2 , Yuval Bloch  2   3
Affiliations

Child and Adolescent Mental Health during the COVID-19 Pandemic: Challenges of Psychiatric Outpatient Clinics

Mariela Mosheva et al. Healthcare (Basel). .

Abstract

Background: Worldwide national surveys show a rising mental health burden among children and adolescents (C&A) during COVID-19. The objective of the current study is to verify the expected rise in visits to psychiatric outpatient clinics of C&A, especially of new patients.

Methods: a cross-sectional study focusing on visits as recorded in electronic medical records of eight heterogeneous C&A psychiatric outpatient clinics. The assessment was based on visits held from March to December of 2019 (before the pandemic) in comparison to visits held in 2020 (during the pandemic).

Results: The number of visits was similar for both periods. However, in 2020, 17% of the visits used telepsychiatry (N = 9885). Excluding telepsychiatry reveals a monthly decrease in traditional in-person activities between 2020 and 2019 (691.6 ± 370.8 in 2020 vs. 809.1 ± 422.8 in 2019, mean difference = -117.5, t (69) = -4.07, p = 0.0002, Cohen's d = -0.30). Acceptation of new patients declined during 2020, compared to 2019 (50.0 ± 38.2 in 2020 vs. 62.8 ± 42.9 in 2019; Z = -3.12, p = 0.002, r = 0.44). Telepsychiatry was not used for new patients.

Conclusions: The activity of C&A psychiatric outpatient clinics did not rise but was guarded due to the use of telepsychiatry. The decline in visits of new patients was explained by the lack of use of telepsychiatry for these patients. This calls for expanding the use of telepsychiatry, especially for new patients.

Keywords: COVID-19; child and adolescence psychiatry; child and adolescents; mental health; outpatient clinic.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Annual trends in visit type and use of telepsychiatry between 2019 and 2020. Y-axis represents the percent of specific visit types out of all annual visits. Data labels represent the cumulative sum of visit types during each year. No error bars are presented due to the use of cumulative sums instead of means.
Figure 2
Figure 2
Monthly visits in 2019 as compared to 2020 (stratified with and without telepsychiatry).
Figure 3
Figure 3
Monthly visits during the lockdown and opening periods in 2019 as compared to 2020. Bars relate to standard deviation. * p < 0.05, *** p < 0.001.
Figure 4
Figure 4
Monthly visits to psychiatric hospitals and general hospitals in 2019 as compared to 2020. Bars relate to standard deviation. ** p < 0.01.
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