Pediatric emergency department mental health assessments in the 2 years following the COVID-19 outbreak reveal higher vulnerability for eating disorder and suicide risk

Background: In the post-COVID era an increase in Emergency Department (ED) mental health assessments has been consistently reported among youth populations. Methods: Pediatric ED mental health assessments in the 2 years following the COVID-19 pandemic (March 2020-February 2022) were compared to those in the immediately preceding same period (March 2018-February 2020), in terms of rates and risk profiles. Results: During the pre-pandemic and post-pandemic periods, 158 and 268 ED accesses were counted respectively, and an overall 1.64 (95 % CI: 1.34–1.99) monthly IRR was estimated. During the post-pandemic period, youth accessing ED were less likely to have a personal history of psychiatric disorders (OR: 0.49; 95 % CI: 0.28–0.86) and to receive an extemporaneous administration of psychopharmacological therapy in ED (OR: 0.28; 95 % CI: 0.14–0.57), despite being more frequently discharged from ED with a background psychopharmacological therapy in place (OR: 2.02; 95 % CI: 1.02–4.01). Finally, during the post-pandemic period, an increase in ED accesses for eating disorder (OR: 2.77; 95 % CI: 1.49–5.13) and suicidal thoughts-self-harm (OR: 2.00; 95 % CI: 1.07–3.74) was observed, when compared to ED access for anxiety-agitation. Conclusions: This report suggests higher rates of post-COVID pediatric ED mental health assessments, especially for eating disorder and suicide risk, with a preponderance of youth whose ED access may be their first mental health specialist contact.