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Introduction The COVID-19 pandemic caused changes to how healthcare services are utilised and delivered. Objectives We examine the impact of COVID-19 on the pattern of emergency patient presentations referred on to the community mental health team and the impact of utilising telemedicine on time to follow-up. Methods We retrospectively reviewed all clinical records of patients currently attending our service. We identified presentations to the emergency department (N=119) who were subsequently referred on for mental health follow-up. Results Patients being referred to our team from emergency departments were significantly younger during, mean age 33.1 years (SD=12.3) compared to before the pandemic, mean age 40.0 years (SD=14.5), p=0.006 and a higher proportion were new patients during, 55.8%, compared to pre-pandemic period 33.3%, p=0.015. There was also a higher proportion of patients presenting with suicidal ideation and lower proportions of affective, psychosis and suicidal/self-injurious acts during the pandemic period compared to before, p=0.006. The ratio of female to male patients on the other hand were similar during both periods, p=0.853. There appeared to be no difference in median time to follow-up pre and during the pandemic (6.0 vs 5.5 days, p=0.995). Further analysis also found no significant impact on time to follow-up upon implementing telemedicine consultations, with median days to initial follow-up of 6 days pre-pandemic, 4.5 days during pandemic + prior to telemedicine and 6.5 days during pandemic + telemedicine, p=0.602. Conclusions This study provides preliminary data on the impact of COVID-19 on mental health emergency presentations and utilization of telemedicine on time to follow-up by CMHTs. Disclosure No significant relationships.

Objective: To examine the association between sexual abuse in childhood and adult depression in women., Design: Two stage, case detection and case identification design, using the 30-item general health questionnaire and the Beck depression inventory for screening and the affective items relating to current functioning on the schizophrenia and affective disorders schedule to identify depressed cases. Details of sexual abuse in childhood were elicited retrospectively by semistructured interview, and social problems by the social problems questionnaire., Setting: Three general practices, in middle class suburban, deprived inner city, and rural areas., Subjects: 1189 women were screened and 237 subsequently interviewed; 132 were depressed., Results: 49 (37%) of the depressed interviews and 24 (23%) of the non-depressed interviews reported experience of sexual abuse when they were aged under 16 years. A positive association existed between the more severe abuse and depression--all those who had experienced penetration were depressed as adults. A relation was also found between sexual abuse in childhood and sexual problems, housing problems, and problems with their children at school., Conclusion: A positive association between child sexual abuse and depression was confirmed, but this was confined to more severe abuse (penetration or attempted penetration).

We compared attendance by Drug Misusers to the Accident & Emergency Departments (A&E) in the greater Dublin area during September 1985 and April 1993. The study took the form of a questionnaire administered by the previously trained A&E staff to attenders who were currently (within the past six months): experimenting with drugs, abusing drugs or drug dependent. Seventy three drug misusers were identified in September 1985 and 68 in April 1993. Poly substance misuse was a major feature of the 1993 survey and Benzodiazepines replaced Heroin as the major drug of misuse. There was a significant increase in the misuse of prescribed opiates, in particular morphine sulphate, methadone and DF118. Physical problems associated with drug misuse were more common in 1993 because of the new trend of crushing and injecting the morphine sulphate tablet. Patients continue to inject drugs and are poor attenders at needle exchange programmes. We feel that all doctors should exercise caution in their prescribing habits in view of the alarming increase in the misuse of prescribed medication as indicated by our figures.