[State of practice: an overview of emergency department visits and hospitalizations among young people aged 6 to 25 for mental health and psychosocial issues in 2022–2023, compared to the pre-pandemic (2016–2020) and pandemic periods (2020–2022) of COVID-19]
Saury S, Moreau A
Record ID 32018011220
French
Original Title:
État des pratiques - Portrait des visites aux urgences et des hospitalisations des jeunes de 6 à 25 ans pour des problématiques de santé mentale et psychosociales en 2022-2023, en comparaison avec les périodes prépandémique (2016-2020) et pandémique de COVID-19 (2020-2022)
Authors' objectives:
The COVID-19 pandemic has had a significant impact on the physical and mental health
and psychological well-being of a large proportion of the population, including young
people. Surveys conducted in Quebec during the pandemic in 2020–2021 showed that
more than half of people aged 15 to 24 had a higher level of psychological distress than
previously. Similarly, in other parts of Canada, the proportion of Canadian youth aged
15 to 24 who reported excellent or good mental health declined in 2020. Meanwhile, in
Europe, according to a 22-country survey, one third of adolescents reported that the
pandemic had had negative impacts on their mental health, with rates higher among
females than males.
The impacts of the pandemic have also been noticed in the health and social services
network, including emergency and hospital care and services. In Quebec, as in the rest of
Canada and elsewhere in the world, declines in emergency department visits and
hospital admissions related to mental health and psychosocial issues were observed in
the first year of the pandemic; such declines were more pronounced among children and
adolescents. Nevertheless, after a decrease in emergency department visits and
hospitalizations at the beginning of the pandemic, increases have been recorded at
similar and sometimes higher levels. The most recent data from across Canada indicates
an increase in emergency department visits and hospitalizations since 2021–2022 for
all age groups, with proportions reaching levels similar to pre-pandemic levels in
2022-2023.
It was in this context that the Institut national d’excellence en santé et en services
sociaux (INESSS) was mandated by the National Director of Public Health to collaborate
with the pan-Canadian research project team Pediatric Outcome imProvement through
CoORdination of Networks (POPCORN) for the purpose of documenting the indirect
consequences of COVID-19 on the mental health of young people in Quebec. In
particular, INESSS was called on to produce an overview of emergency department
visits and hospitalizations for mental health and psychosocial issues among all young
people aged 6 to 25 in Quebec in 2022–2023, compared to the pre-pandemic period
(2016-2020) and the pandemic period (2020–2022).
Authors' results and conclusions:
RESULTS (#1 EMERGENCY DEPARTMENT VISITS AND HOSPITALIZATIONS AMONG YOUTH AGED 6 TO 25): Among young people between the ages of 6 and 25, there were approximately
46,300 emergency department visits in 2022–2023 (representing 7% of total emergency
department visits for this age group) and approximately 8,900 hospitalizations (19.3% of
total hospitalizations for this age group) for mental health and psychosocial issues.
After a significant decline in the early days of the pandemic, there was an increase in the
number of emergency department visits and hospitalizations for mental health and
psychosocial issues among this population, albeit not to their pre-pandemic levels. (#2 SOCIODEMOGRAPHIC CHARACTERISTICS OF YOUTH WHO VISITED EMERGENCY DEPARTMENTS OR
WERE HOSPITALIZED FOR MENTAL HEALTH AND PSYCHOSOCIAL ISSUES): Young people aged 18 to 25 accounted for the majority of emergency department visits
and hospitalizations attributable to mental health and psychosocial issues, followed by
youth aged 12 to 17. Women accounted for approximately 60% of emergency
department visits and hospitalizations for mental health and psychosocial issues. (#3 MENTAL HEALTH AND PSYCHOSOCIAL ISSUES RELATED TO EMERGENCY DEPARTMENT VISITS AND
HOSPITALIZATIONS): Compared to the pre-pandemic period (2016–2017 to 2019–2020), the number of
emergency department visits and hospitalizations for most mental health and
psychosocial issues decreased in 2022–2023, with the exception of emergency
department visits attributable to eating disorders, suicidal ideation and suicide attempts,
and of hospitalizations attributable to eating disorders and suicide attempts (including
intoxication or self-inflicted traumatic injuries). The incidences of these problems
increased significantly in emergency departments and hospitalizations alike. There was a
particularly significant uptick among females visiting the emergency department. It should
be noted, however, that eating disorders accounts for relatively few emergency
department visits and hospitalizations.
CONCLUSION: This overview provides contemporary information and includes clinico-administrative data
describing emergency department visits and hospitalizations among all young people
aged 6 to 25 for mental health and psychosocial problems in Quebec from 2016–2017 to
2022–2023.
Overall, in 2022–2023 a larger number of females and people aged 18 to 25 visited
emergency departments and were hospitalized. Moreover, since the pandemic, it has
been observed that a significant increase of emergency department visits and
hospitalization episodes are attributable to eating disorders, suicidal ideation and suicide
attempts. Mental health issues in Quebec, elsewhere in Canada and internationally have
also been documented by population-based surveys that point to growing needs among
young people. Further work is required to assess and interpret the findings, to better
understand the needs of young people aged 6 to 25 and to propose best clinical and
organizational practices for addressing these needs.
Authors' methods:
This overview was drawn up using data from two different databases namely the “Banque
de données communes des urgences” (BDCU) and the “Maintenance et exploitation des
données pour l’étude de la clientèle hospitalière” (MED-ECHO) file. Population data was
derived from population estimates and projections produced by the Institut de la
statistique du Québec and Statistics Canada.
The study population represented all youth aged 6 to 25 from the 18 health regions of
Quebec who had made at least one emergency department visit or had been hospitalized
at least once during the study period (fiscal periods 2016–2017 to 2022–2023).
The specific objectives of the overview were as follows:
• Describe emergency department visits for various mental health and psychosocial
issues in 2022–2023 and compare between 2016 and 2023 among youth aged 6
to 25 years.
• Describe hospitalizations for various mental health and psychosocial issues in
2022–2023 and compare between 2016 and 2023 among young people aged 6 to
25 years.
The variables of interest were based on the primary diagnosis and reason for the
emergency department visits and mainly on the primary diagnosis made during
hospitalizations. Comparisons were made of the emergency and hospital care and
services between 2022–2023 and the pre-pandemic period (April 1, 2016 to March 31,
2020) and the pandemic period (April 1, 2020 to March 31, 2022).
This report was subject to internal validation by the departments responsible for its
production and external validation by experts in the field in order to ensure the quality of
the work.
Details
Project Status:
Completed
Year Published:
2024
English language abstract:
An English language summary is available
Publication Type:
Other
Country:
Canada
Province:
Quebec
MeSH Terms
- Emergency Room Visits
- Emergency Service, Hospital
- Emergency Services, Psychiatric
- Adolescent
- Adolescent Health Services
- Child Health Services
- Child
- Young Adult
- Mental Health Services
- Mental Health
- Psychosocial Functioning
- Anxiety
- COVID-19
- Pandemics
- Depression
Contact
Organisation Name:
Institut national d'excellence en sante et en services sociaux
Contact Address:
L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369
Contact Name:
demande@inesss.qc.ca
Contact Email:
demande@inesss.qc.ca
Copyright:
L'Institut national d'excellence en sante et en services sociaux (INESSS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.