Hospitalizations for Mental Health Conditions Increased During the Pandemic Among Adolescents

Throughout the COVID-19 pandemic, various studies have documented increases in depression, anxiety, and suicidality among adolescents. This increase has been associated, at least in part, to the extensive disruptions caused by social distancing measures that impacted routine educational and recreational activities and limited social interactions with peers.

Adolescents with severe mental health conditions may require hospitalization if they are at risk of self-harm and unable to be safely maintained at home. A recent study sought to determine whether the pandemic caused an increase in the monthly proportion of hospitalization associated with mental health conditions among adolescents.

“Assessing changes in the proportion of hospitalizations for mental health conditions among adolescents is critical to ensure the prioritization of public health programs targeting psychiatric health care needs that have emerged during the pandemic,” the study authors wrote. “It is also necessary to better understand the health care infrastructure and resources required to provide high-quality mental health care to these patients.”

Authors designed a cohort study drawing data from a sample of sites participating in the Consortium for Clinical Characterization of COVID-19 (4CE). Participants were 11-17 years of age and had a hospitalization associated with at least 1 diagnosis of a mental health condition between February 1, 2019, and April 30, 2021. In total, data came from 8 pediatric hospitals—5 from the United States and 3 from France.

To examine the changes in the proportions of hospitalizations, authors denoted a prepandemic period from February 1, 2019, to March 31, 2020, and a pandemic period from April 1, 2020, to April 30, 2021. The inclusion criteria included 9696 adolescents who had at least 1 mental health condition-associated hospitalization during the prepandemic period, and 11,101 during the pandemic period.

At the time of hospitalization, the mean age was 14.6 years in the prepandemic cohort, and 14.7 in the pandemic cohort. Additionally, there was a greater proportion of females than males hospitalized in both periods (5966 [61.5% vs 3730 [38.5%]; P <.001) (7603 [68.5%] vs 3498 [31.5%]; P <.001) in the prepandemic and pandemic group, respectively. Notably, the 3 most prevalent mental health conditions across the study population were anxiety, depression, and suicidality or self-harm.

“Our results are consistent with prior studies, highlighting the potential association of pandemic-related disruptions with adolescent social, emotional, and behavioral well-being,” the study authors wrote. “The greater illness burden observed among female adolescents is also in line with findings reported in other analyses.”

Overall, the study noted that in the prepandemic period, hospitals reported 36,059 total hospitalizations, of which 12,122 (33.6%) were related to mental health. Comparatively, in the pandemic period, 11,605 of 31,908 (36.4%) of hospitalizations were related to mental health. This significant increase (.60% [95% CI. 0.31%-0.89%]) was found at 4 of 5 hospitals in the United States and 1 of 3 in France.

“We observed high proportions of hospitalizations associated with anxiety, depression, and suicidality or self-injury during the pandemic…these findings support the need for ongoing prioritization of resources for children’s hospitals to provide care to adolescents with mental health conditions,” the study authors wrote.

References

Gutierrez-Sacristan A, Serret-Larmande A, Hutch M, et al. Hospitalizations associated with mental health conditions among adolescents in the US and France during the COVID-19 pandemic. JAMA Netw Open. 2022;5(12):e2246548. doi:10.1001/jamanetworkopen.2022.46548