The impact of the COVID-19 pandemic on children and adolescent mental health in-patient service use in England: interrupted time-series analysis of national patient records
Background During the initial phases of the COVID-19 pandemic, children and young people (CYP) faced significant restrictions. The virus and mitigation approaches significantly impacted how health services could function and be safely delivered. Aims To investigate the impact of COVID-19 lockdowns...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2024-03-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472424000097/type/journal_article |
| _version_ | 1797253815257268224 |
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| author | Apostolos Tsiachristas Josephine Holland Boliang Guo Prathiba Chitsabesan Kapil Sayal Anees Ahmed Abdul Pari |
| author_facet | Apostolos Tsiachristas Josephine Holland Boliang Guo Prathiba Chitsabesan Kapil Sayal Anees Ahmed Abdul Pari |
| author_sort | Apostolos Tsiachristas |
| collection | DOAJ |
| description | Background
During the initial phases of the COVID-19 pandemic, children and young people (CYP) faced significant restrictions. The virus and mitigation approaches significantly impacted how health services could function and be safely delivered.
Aims
To investigate the impact of COVID-19 lockdowns on CYP psychiatric admission trends during lockdown 1 (started 23 Mar 2020) and lockdown 2 (started 5 Nov 2020) of the COVID-19 pandemic in England.
Method
Routinely collected, retrospective English administrative data regarding psychiatric hospital admissions, length of stay and patient demographic factors were analysed using an interrupted time series analysis (ITSA) to estimate the impact of COVID-19 lockdowns 1 and 2 on service use trends. We analysed data of 6250 CYP (up to 18 years of age) using ordinary least squares (OLS) regression analysis with Newey–West standard errors to handle autocorrelation and heteroscedasticity.
Results
Psychiatric hospital admissions for CYP significantly fell during lockdown 1, and then fell even further during lockdown 2. A greater proportion of admissions during lockdown were out of area or to independent sector units. During lockdown, the average age of CYP admitted was higher, and a greater proportion were female. There was also a significant increase in the proportion of looked-after children and CYP from the most socioeconomically deprived areas admitted during lockdown 2.
Conclusions
During both lockdowns, fewer CYP had psychiatric admissions. The subsequent rise in admissions for more socioeconomically deprived CYP and looked-after children suggests that these CYP may have been disproportionately affected by the pandemic, or overlooked during earlier phases.
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| first_indexed | 2024-04-24T21:40:03Z |
| format | Article |
| id | doaj.art-ff81adc7dad0410391bb7b45a96f0fd5 |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-04-24T21:40:03Z |
| publishDate | 2024-03-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-ff81adc7dad0410391bb7b45a96f0fd52024-03-21T09:17:18ZengCambridge University PressBJPsych Open2056-47242024-03-011010.1192/bjo.2024.9The impact of the COVID-19 pandemic on children and adolescent mental health in-patient service use in England: interrupted time-series analysis of national patient recordsApostolos Tsiachristas0https://orcid.org/0000-0002-4662-8915Josephine Holland1Boliang Guo2https://orcid.org/0000-0002-1844-705XPrathiba Chitsabesan3Kapil Sayal4Anees Ahmed Abdul Pari5Nuffield Department of Primary Care Health Sciences & Department of Psychiatry, University of Oxford, UKMental Health and Clinical Neurosciences, Institute of Mental Health, University of Nottingham, UKMental Health and Clinical Neurosciences, Institute of Mental Health, University of Nottingham, UKPennine Care NHS Foundation Trust, Manchester, UKMental Health and Clinical Neurosciences, Institute of Mental Health, University of Nottingham, UKNHS England, East of England, Cambridge, UKBackground During the initial phases of the COVID-19 pandemic, children and young people (CYP) faced significant restrictions. The virus and mitigation approaches significantly impacted how health services could function and be safely delivered. Aims To investigate the impact of COVID-19 lockdowns on CYP psychiatric admission trends during lockdown 1 (started 23 Mar 2020) and lockdown 2 (started 5 Nov 2020) of the COVID-19 pandemic in England. Method Routinely collected, retrospective English administrative data regarding psychiatric hospital admissions, length of stay and patient demographic factors were analysed using an interrupted time series analysis (ITSA) to estimate the impact of COVID-19 lockdowns 1 and 2 on service use trends. We analysed data of 6250 CYP (up to 18 years of age) using ordinary least squares (OLS) regression analysis with Newey–West standard errors to handle autocorrelation and heteroscedasticity. Results Psychiatric hospital admissions for CYP significantly fell during lockdown 1, and then fell even further during lockdown 2. A greater proportion of admissions during lockdown were out of area or to independent sector units. During lockdown, the average age of CYP admitted was higher, and a greater proportion were female. There was also a significant increase in the proportion of looked-after children and CYP from the most socioeconomically deprived areas admitted during lockdown 2. Conclusions During both lockdowns, fewer CYP had psychiatric admissions. The subsequent rise in admissions for more socioeconomically deprived CYP and looked-after children suggests that these CYP may have been disproportionately affected by the pandemic, or overlooked during earlier phases. https://www.cambridge.org/core/product/identifier/S2056472424000097/type/journal_articleIn-patient treatmentcommunity mental health teamsCOVID-19pandemicpsychiatric hospital admissions |
| spellingShingle | Apostolos Tsiachristas Josephine Holland Boliang Guo Prathiba Chitsabesan Kapil Sayal Anees Ahmed Abdul Pari The impact of the COVID-19 pandemic on children and adolescent mental health in-patient service use in England: interrupted time-series analysis of national patient records BJPsych Open In-patient treatment community mental health teams COVID-19 pandemic psychiatric hospital admissions |
| title | The impact of the COVID-19 pandemic on children and adolescent mental health in-patient service use in England: interrupted time-series analysis of national patient records |
| title_full | The impact of the COVID-19 pandemic on children and adolescent mental health in-patient service use in England: interrupted time-series analysis of national patient records |
| title_fullStr | The impact of the COVID-19 pandemic on children and adolescent mental health in-patient service use in England: interrupted time-series analysis of national patient records |
| title_full_unstemmed | The impact of the COVID-19 pandemic on children and adolescent mental health in-patient service use in England: interrupted time-series analysis of national patient records |
| title_short | The impact of the COVID-19 pandemic on children and adolescent mental health in-patient service use in England: interrupted time-series analysis of national patient records |
| title_sort | impact of the covid 19 pandemic on children and adolescent mental health in patient service use in england interrupted time series analysis of national patient records |
| topic | In-patient treatment community mental health teams COVID-19 pandemic psychiatric hospital admissions |
| url | https://www.cambridge.org/core/product/identifier/S2056472424000097/type/journal_article |
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