Mental health hospitalizations among adolescents in the US and France increased during the pandemic

Survey data support the need for improved global health policies related to adolescent mental health, a new study finds.

A study released this week found that the COVID-19 pandemic is linked to an increase in hospitalizations among young people with mental illness.

While it is already known that the pandemic has had a detrimental effect on mental health, the extent of the problem, particularly in terms of severe conditions requiring hospitalization, including anxiety, depression and self-harm or suicidal tendencies, is not known.

The retrospective cohort study published in JAMA Network Openaimed to assess change in adolescent hospitalizations.

Patients were included if they were between the ages of 11–17 years and had at least 1 psychiatric hospitalization between February 1, 2019, and April 30, 2021. These patients came from 8 different pediatric hospitals in the United States ( 5 ) and France (3) participating in the Consortium for Clinical Characterization of COVID-19 (4CE). The consortium is focused on clinical research of COVID-19 using data from electronic health records.

The study compared 9,696 adolescents who were hospitalized with at least 1 mental illness in the pre-pandemic period (February 1, 2019 to March 30, 2020) with 11,101 adolescents during the pandemic period (April 1, 2020 to April 30, 2021 . ).

The mean (SD) age in the pre-pandemic group was 14.6 years and 14.7 years in the pandemic group.

Results showed an overall increase of 0.60% (95% CI, 0.31%-0.89%) in hospitalizations per month during the pandemic period compared with hospitalizations before the pandemic.

In addition to the overall increase in hospitalizations, the study found that most affected patients were women in both the pre-pandemic (61.5%) and pandemic (68.5%) periods.

The most prevalent mental health conditions during the pandemic were anxiety (0.55%; 95% CI, 0.26%-0.84%), depression (0.50%; 95% CI, 0.19%- 0.79%) and suicidality or self-harm (0.38%; 95% CI, 0.08%-0.68%).

The authors acknowledge some limitations of their findings. First, they failed to determine the underlying cause of hospitalizations and instead used all hospitalizations with at least 1 mental illness to examine changes over time. Second, because the authors extracted data prespecified for 4CE, there was limited opportunity to test other patient characteristics outside of the 4CE network data.

It is also important to note that prior to the pandemic, there were already high numbers of adolescent hospitalizations related to anxiety, depression, and suicidality or self-harm. More than 40% of adolescents who were hospitalized before the pandemic were diagnosed with 1 of 3 mental illnesses.

The authors attribute social isolation and other disruptions to the COVID-19 pandemic as possible exacerbating factors for this increased trend in adolescent hospitalizations.

Despite these limitations, increased trends in mental health-related hospitalizations suggest a need for continued support and prioritization of resources within pediatric health care.

“Quantifying change in mental health burden provides data to guide future global public health policies and programs to improve access to high-quality mental health care in outpatient and inpatient settings, even after the COVID-19 pandemic.” the authors conclude.

reference

Gutiérrez-Sacristán A, Serret-Larmande A, Hutch MR, et al. Hospitalizations related to mental illness among adolescents in the United States and France during the COVID-19 pandemic. JAMA Network Open. 2022; 5 (12). doi:10.1001/jamanetworkopen.2022.46548

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