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Acute mental health presentations before and during the COVID-19 pandemic

Research output: Contribution to Journal/Magazine › Journal article › peer-review

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Acute mental health presentations before and during the COVID-19 pandemic. / Mukadam, Naaheed; Sommerlad, Andrew; Wright, Jessica et al.
In: BJPsych Open, Vol. 7, No. 4, e134, 16.07.2021, p. 1-8.

Research output: Contribution to Journal/Magazine › Journal article › peer-review

Harvard

Mukadam, N, Sommerlad, A, Wright, J, Smith, A, Szczap, A, Solomou, S, Bhome, R, Thayalan, R, Abrol, E, Aref-Adib, G, Maconick, L, Aubrey-Jones, D, Tugrul, S, Knowles, M, Menys, H, Sathanandan, S, Moslehi, S, Huntley, J, Liu, K & Carlos Bazo-Alvarez, J 2021, 'Acute mental health presentations before and during the COVID-19 pandemic', BJPsych Open, vol. 7, no. 4, e134, pp. 1-8. https://doi.org/10.1192/bjo.2021.970

APA

Mukadam, N., Sommerlad, A., Wright, J., Smith, A., Szczap, A., Solomou, S., Bhome, R., Thayalan, R., Abrol, E., Aref-Adib, G., Maconick, L., Aubrey-Jones, D., Tugrul, S., Knowles, M., Menys, H., Sathanandan, S., Moslehi, S., Huntley, J., Liu, K., & Carlos Bazo-Alvarez, J. (2021). Acute mental health presentations before and during the COVID-19 pandemic. BJPsych Open, 7(4), 1-8. Article e134. https://doi.org/10.1192/bjo.2021.970

Vancouver

Mukadam N, Sommerlad A, Wright J, Smith A, Szczap A, Solomou S et al. Acute mental health presentations before and during the COVID-19 pandemic. BJPsych Open. 2021 Jul 16;7(4):1-8. e134. doi: 10.1192/bjo.2021.970

Author

Mukadam, Naaheed ; Sommerlad, Andrew ; Wright, Jessica et al. / Acute mental health presentations before and during the COVID-19 pandemic. In: BJPsych Open. 2021 ; Vol. 7, No. 4. pp. 1-8.

Bibtex

@article{6a73bf3baf904f3d9cc627393fe873ee,
title = "Acute mental health presentations before and during the COVID-19 pandemic",
abstract = "BACKGROUND: A number of community based surveys have identified an increase in psychological symptoms and distress but there has been no examination of symptoms at the more severe end of the mental health spectrum.AIMS: We aimed to analyse numbers and types of psychiatric presentations to inform planning for future demand on mental health services in light of the COVID-19 pandemic.METHOD: We analysed electronic data between January and April 2020 for 2534 patients referred to acute psychiatric services, and tested for differences in patient demographics, symptom severity and use of the Mental Health Act 1983 (MHA), before and after lockdown. We used interrupted time-series analyses to compare trends in emergency department and psychiatric presentations until December 2020.RESULTS: There were 22% fewer psychiatric presentations the first week and 48% fewer emergency department presentations in the first month after lockdown initiated. A higher proportion of patients were detained under the MHA (22.2 v. 16.1%) and Mental Capacity Act 2005 (2.2 v. 1.1%) (χ2(2) = 16.3, P < 0.0001), and they experienced a longer duration of symptoms before seeking help from mental health services (χ2(3) = 18.6, P < 0.0001). A higher proportion of patients presented with psychotic symptoms (23.3 v. 17.0%) or delirium (7.0 v. 3.6%), and fewer had self-harm behaviour (43.8 v. 52.0%, χ2(7) = 28.7, P < 0.0001). A higher proportion were admitted to psychiatric in-patient units (22.2 v. 18.3%) (χ2(6) = 42.8, P < 0.0001) after lockdown.CONCLUSIONS: UK lockdown resulted in fewer psychiatric presentations, but those who presented were more likely to have severe symptoms, be detained under the MHA and be admitted to hospital. Psychiatric services should ensure provision of care for these patients as well as planning for those affected by future COVID-19 waves.",
keywords = "Suicide, community mental health teams, self-harm, depressive disorders",
author = "Naaheed Mukadam and Andrew Sommerlad and Jessica Wright and Abigail Smith and Aleksandra Szczap and Solomis Solomou and Rohan Bhome and Roshan Thayalan and Esha Abrol and Golnar Aref-Adib and Lucy Maconick and Dominic Aubrey-Jones and Senem Tugrul and Melanie Knowles and Helen Menys and Shivanthi Sathanandan and Sarah Moslehi and Jonathan Huntley and Kathy Liu and {Carlos Bazo-Alvarez}, Juan",
year = "2021",
month = jul,
day = "16",
doi = "10.1192/bjo.2021.970",
language = "English",
volume = "7",
pages = "1--8",
journal = "BJPsych Open",
issn = "2056-4724",
publisher = "Cambridge University Press",
number = "4",

}

RIS

TY - JOUR

T1 - Acute mental health presentations before and during the COVID-19 pandemic

AU - Mukadam, Naaheed

AU - Sommerlad, Andrew

AU - Wright, Jessica

AU - Smith, Abigail

AU - Szczap, Aleksandra

AU - Solomou, Solomis

AU - Bhome, Rohan

AU - Thayalan, Roshan

AU - Abrol, Esha

AU - Aref-Adib, Golnar

AU - Maconick, Lucy

AU - Aubrey-Jones, Dominic

AU - Tugrul, Senem

AU - Knowles, Melanie

AU - Menys, Helen

AU - Sathanandan, Shivanthi

AU - Moslehi, Sarah

AU - Huntley, Jonathan

AU - Liu, Kathy

AU - Carlos Bazo-Alvarez, Juan

PY - 2021/7/16

Y1 - 2021/7/16

N2 - BACKGROUND: A number of community based surveys have identified an increase in psychological symptoms and distress but there has been no examination of symptoms at the more severe end of the mental health spectrum.AIMS: We aimed to analyse numbers and types of psychiatric presentations to inform planning for future demand on mental health services in light of the COVID-19 pandemic.METHOD: We analysed electronic data between January and April 2020 for 2534 patients referred to acute psychiatric services, and tested for differences in patient demographics, symptom severity and use of the Mental Health Act 1983 (MHA), before and after lockdown. We used interrupted time-series analyses to compare trends in emergency department and psychiatric presentations until December 2020.RESULTS: There were 22% fewer psychiatric presentations the first week and 48% fewer emergency department presentations in the first month after lockdown initiated. A higher proportion of patients were detained under the MHA (22.2 v. 16.1%) and Mental Capacity Act 2005 (2.2 v. 1.1%) (χ2(2) = 16.3, P < 0.0001), and they experienced a longer duration of symptoms before seeking help from mental health services (χ2(3) = 18.6, P < 0.0001). A higher proportion of patients presented with psychotic symptoms (23.3 v. 17.0%) or delirium (7.0 v. 3.6%), and fewer had self-harm behaviour (43.8 v. 52.0%, χ2(7) = 28.7, P < 0.0001). A higher proportion were admitted to psychiatric in-patient units (22.2 v. 18.3%) (χ2(6) = 42.8, P < 0.0001) after lockdown.CONCLUSIONS: UK lockdown resulted in fewer psychiatric presentations, but those who presented were more likely to have severe symptoms, be detained under the MHA and be admitted to hospital. Psychiatric services should ensure provision of care for these patients as well as planning for those affected by future COVID-19 waves.

AB - BACKGROUND: A number of community based surveys have identified an increase in psychological symptoms and distress but there has been no examination of symptoms at the more severe end of the mental health spectrum.AIMS: We aimed to analyse numbers and types of psychiatric presentations to inform planning for future demand on mental health services in light of the COVID-19 pandemic.METHOD: We analysed electronic data between January and April 2020 for 2534 patients referred to acute psychiatric services, and tested for differences in patient demographics, symptom severity and use of the Mental Health Act 1983 (MHA), before and after lockdown. We used interrupted time-series analyses to compare trends in emergency department and psychiatric presentations until December 2020.RESULTS: There were 22% fewer psychiatric presentations the first week and 48% fewer emergency department presentations in the first month after lockdown initiated. A higher proportion of patients were detained under the MHA (22.2 v. 16.1%) and Mental Capacity Act 2005 (2.2 v. 1.1%) (χ2(2) = 16.3, P < 0.0001), and they experienced a longer duration of symptoms before seeking help from mental health services (χ2(3) = 18.6, P < 0.0001). A higher proportion of patients presented with psychotic symptoms (23.3 v. 17.0%) or delirium (7.0 v. 3.6%), and fewer had self-harm behaviour (43.8 v. 52.0%, χ2(7) = 28.7, P < 0.0001). A higher proportion were admitted to psychiatric in-patient units (22.2 v. 18.3%) (χ2(6) = 42.8, P < 0.0001) after lockdown.CONCLUSIONS: UK lockdown resulted in fewer psychiatric presentations, but those who presented were more likely to have severe symptoms, be detained under the MHA and be admitted to hospital. Psychiatric services should ensure provision of care for these patients as well as planning for those affected by future COVID-19 waves.

KW - Suicide

KW - community mental health teams

KW - self-harm

KW - depressive disorders

U2 - 10.1192/bjo.2021.970

DO - 10.1192/bjo.2021.970

M3 - Journal article

C2 - 34266510

VL - 7

SP - 1

EP - 8

JO - BJPsych Open

JF - BJPsych Open

SN - 2056-4724

IS - 4

M1 - e134

ER -