Table 1 Summary of paper included in this review
Author, Publication date, Country | Sample/data source | Age | Numbers before pandemic | Numbers during pandemic | Percentage change | Key findings |
|---|---|---|---|---|---|---|
Bothara et al. (2020), New Zealand | Paediatric patients who visited the emergency department (ED) at Christchurch Hospital | Up to 15 years of age | ED visits for psychiatric issues | Reduction in mental health diagnoses and patients presenting with suicidal thoughts, but increase in patients presenting with self-harm (sub-analysis) | ||
20 | 4 | − 80% | ||||
ED visits due to self-harm | ||||||
0 | 6 | N/A | ||||
ED visits due to suicidal ideation | ||||||
5 | 0 | N/A | ||||
Cheek et al. (2020), Australia | Paediatric patients with mental health diagnoses in four Victorian hospitals | Up to 17 years of age | ED visits for psychiatric issues | ED visits with mental health diagnoses increased (sub-analysis) | ||
485 | 656 | + 35.3% | ||||
Chen et al. (2020), UK | General population receiving secondary care mental health clinical services from Cambridgeshire and Peterborough NHS Foundation Trust | 0–19 years of age (subgroup) | Referrals to secondary mental health services (mean per day during lockdown 2020 versus same period in 2019) | Substantial reduction in the initial number of referrals per day following lockdown, but no significant acceleration after lockdown | ||
33.39 | 19 | − 43.1% | ||||
de Neira et al. (2020), Spain | Adolescents who visited the ED or were hospitalized in the Acute Inpatient Unit at the Puerta de Hierro University Hospital-Majadahonda | Up to 17 years of age Mean and SD: 14.2 ± 2.3 (pre- pandemic) and 15.36 ± 1.8 (during) | ED visits for psychiatric issues | Visits to ED and admissions to adolescent inpatient unit decreased. Average hospital stays in the adolescent inpatient unit also decreased | ||
64 | 25 | − 60.9% | ||||
Admissions to psychiatric inpatient unit | ||||||
31 | 18 | − 41·9% | ||||
Average hospital stay (mean days) | ||||||
14.32 | 8.94 | − 37.6% (ns) | ||||
Goldman et al. (2020), Canada | Pediatric patients who attended 18 EDs in British Columbia, Canada | Up to 16 years of age | Not provided | Not provided | − 41% (from original article) | ED visits for mental health issues fell by 41% (sub-analysis) |
Hill et al. (2021), USA | Paediatric patients who were screened for suicide risk by a large paediatric emergency department in a major metropolitan area in Texas | 11–21 years of age Mean and SD: 14.52 ± 2.22 | ED visits due to suicidal ideation | Rates of suicide ideation were not uniformly higher in January to July 2020, compared to 2019. However, there were significantly higher rates of suicide ideation in March and July 2020 and higher rates of suicide attempts in February, March, April and July 2020. Rates corresponded with heightened COVID-19 restrictions. Suicide ideation was more frequent in 2020 and among females | ||
1134 | 899 | − 20.7% | ||||
ED visits following suicide attempts | ||||||
268 | 286 | + 6.7% | ||||
Isumi et al. (2020), Japan | National suicide deaths statistics | Up to 19 years of age | Not provided | Not provided | Not provided | The first wave (March to May 2020) of the COVID-19 pandemic has not significantly affected suicide rates among children and adolescents |
Leeb et al. (2020), USA | Children and adolescents attended ED based on CDC’s National Syndromic Surveillance Program (NSSP) data which include a subset of hospitals in 47 states | Up to 17 years of age | ED visits for psychiatric issues (average weekly total visits) | ED visits decreased sharply from mid-March 2020 through early April, and then increased steadily through October 2020 compared to in 2019 | ||
3025 | 2872 | − 5.1% | ||||
Leff et al. (2020), USA | Paediatric patients with mental health diagnoses who presented to the paediatric ED at Yale New Haven Children’s Hospital | Up to 15 years of age | ED visits for psychiatric issues | Psychiatric-related visits were reduced. Black children were half as likely (OR = 0.55, 95% CI 0.36–0.85) to present with mental health conditions that may have signified delayed unmet needs than white children. Females continued to visit ED more than males, as they did before the pandemic period | ||
378 | 148 | − 60.8% | ||||
Levene et al. (2021), USA | Paediatric patients seen by the paediatric ED of a quarternary children’s hospital | Up to 20 years of age | ED visits for psychiatric issues | Psychiatric and psychosocial visits declined (sub-analysis) | ||
607 | 197 | − 67.5% | ||||
Ougrin et al. (2020), 10 countries and regions | Children and young people who presented with self-harm to 23 hospital EDs in 10 countries/regions: England (3 areas), Scotland (2 areas), Italy (2 areas), Ireland, Austria, Hungary, Serbia, Turkey, Oman and the United Arab Emirates | Up to 18 years of age Mean and SD 15.2 ± 2.0 (pre) and 15.4 ± 1.7 (during) | ED visits due to self-harm | ED visits for psychiatric issues were reduced, specifically emergency psychiatric presentations for self-harm. Self-harm patients were mainly female, average age 15 years old, from the countries’ dominant ethnic groups, in education, employment or training and not looked after by the local authority | ||
612 | 470 | − 23.2% | ||||
ED visits for psychiatric issues | ||||||
1239 | 834 | − 32.7% | ||||
Admission to psychiatric inpatient units (England only) | ||||||
753 | 550 | − 27.0% | ||||
Pelletier et al. (2021), USA | Patients seen by 49 paediatric hospitals in the USA | Median (Interquartile range): 5.1 years of age (0.7–13.3) | Not provided | Not provided | Not provided | Reductions in mental health admissions (sub-analysis) |
Pignon et al. (2020), France | General population seen by three psychiatric emergency centres in Paris, Colombes and Créteil | 16–24 years of age (subgroup) | Psychiatric ED consultations | Significant decrease in emergency psychiatric consultations | ||
337 | 120 | − 64.4% | ||||
Raucci et al. (2021), Italy | Patients seen by EDs in two children hospitals in Rome and Palidoro | Not provided | ED visits for psychiatric issues | Reduction in visits and admissions due to mental health (sub-analysis) | ||
216 | 159 | − 26.3% | ||||
Psychiatric ED admissions | ||||||
87 | 74 | − 14.9% (ns) | ||||
Sokoloff et al. (2021), USA | Patients seen by a paediatric ED in a tertiary care children’s hospital in New York City | Up to 17 years of age | Psychiatric ED visits | Reduction in visits due to mental health, but increased visits due to suicidal ideation, suicide attempts or self-harm (sub-analysis) | ||
497 (Mean 2018 and 2019) | 180 | − 63·8% | ||||
ED visits due to suicidal ideation, suicide attempts, or self-harm | ||||||
11 (Mean 2018 and 2019) | 22 | + 50% | ||||
Tanaka & Okamoto (2021), Japan | National suicide deaths statistics | Up to 19 years of age (subgroup) | Not provided | Not provided | Not provided | Suicide rate among children and adolescents increased 49% in the second wave (July to October 2020) of the pandemic corresponding to after the end of the nationwide school closure |
Tromans et al. (2020), UK | General population who accessed secondary mental health services run by Leicestershire Partnership NHS Trust | Child and adolescent mental health services (sub-group) | Referrals to secondary mental health services | Significantly reduced referrals to child and adolescent secondary mental health services during lockdown | ||
2193 | 1081 | − 50·7% | ||||
Admissions to secondary mental health services | ||||||
14 | 17 | + 21·4% (ns) | ||||
Yaffa et al. (2020), Israel | Patients with eating disorders treatment seen by the Safra Children’s Hospital at the Sheba Medical Center, Tel Hashomer | 6–18 years of age | Patients received eating disorder treatment | Increased in number of treatment sessions provided for eating disorders, partly due to telemedicine. Slightly fewer patients | ||
423 (Mean 2015–2019) | 369 | − 12·8% | ||||
Face-to-face and online sessions provided for eating disorder treatment | ||||||
4001 (Mean 2015–2019) | 5926 | + 48·1% | ||||