Seasonality and school day-based trends in mental-health-related pediatric emergency department visits during COVID-19 in British Columbia

ObjectivesThe association between mental health related pediatric emergency department (ED) visits and school attendance during the COVID-19 pandemic remains unclear. We aimed to determine the change in rate of mental health-related pediatric ED visits related to type of school day (i.e., school closure days, school days, winter/summer break days) during the pandemic. We also aimed to compare the number of presentations per week during pandemic school periods to expected values based on pre-pandemic trends.MethodsWe included all pediatric ED visits by children aged 2-17 years between January 1st, 2014, and December 31st, 2022, at a single quaternary pediatric center. We calculated the rate (number of mental health pediatric ED visits by 100,000 children) in British Columbia per day on each type of school day, as well as the rate of visits per week during each school period of the pandemic in comparison to the expected values.ResultsThere was a 36% decrease in presentation rates on non-school days relative to school days in both pre-pandemic and pandemic periods. During the two periods of school closure due to pandemic protocols, mental health visits were substantially lower compared to school days during the pandemic. There were fewer mental health pediatric ED visits for three of the four pandemic school years when compared to pre-pandemic trends.ConclusionsMental health-related pediatric ED visits were consistently higher on school days than non-school days, including COVID-19 school closure days. In comparison to expected rates based on pre-pandemic trends, mental health-related pediatric ED visits decreased in three of the four school years during the pandemic. Our findings suggest an increased need for mental health support in the ED on school days. They also suggest that EDs should be prepared for mental health demands alongside surges and pandemics. ObjectifsL'association entre les visites aux services d'urgence p & eacute;diatriques (DE) et la fr & eacute;quentation scolaire pendant la pand & eacute;mie de COVID-19 demeure incertaine. Nous avons cherch & eacute; & agrave; d & eacute;terminer l'& eacute;volution du taux de visites p & eacute;diatriques en salle d'urgence li & eacute;es & agrave; la sant & eacute; mentale et li & eacute;es au type de journ & eacute;e scolaire (jours de fermeture des & eacute;coles, journ & eacute;es scolaires, jours de rel & acirc;che hivernale/estivale) pendant la pand & eacute;mie. Nous avons & eacute;galement cherch & eacute; & agrave; comparer le nombre de pr & eacute;sentations par semaine pendant les p & eacute;riodes scolaires de la pand & eacute;mie aux valeurs attendues en fonction des tendances pr & eacute;pand & eacute;miques.M & eacute;thodes Nous avons inclus toutes les visites p & eacute;diatriques en DE d'enfants & acirc;g & eacute;s de 2 & agrave; 17 ans entre le 1er janvier 2014 et le 31 d & eacute;cembre 2022 dans un seul centre quaternaire. Nous avons calcul & eacute; le taux (nombre de visites p & eacute;diatriques en urgence pour 100000 enfants) en Colombie-Britannique par jour pour chaque type de journ & eacute;e scolaire, ainsi que le taux de visites par semaine pendant chaque p & eacute;riode scolaire de la pand & eacute;mie par rapport aux valeurs attendues.R & eacute;sultatsIl y a eu une diminution de 36 % des taux de pr & eacute;sentation les jours non scolaires par rapport aux jours d'& eacute;cole dans la p & eacute;riode pr & eacute;pand & eacute;mique et la p & eacute;riode pand & eacute;mique. Pendant les deux p & eacute;riodes de fermeture des & eacute;coles en raison des protocoles de la pand & eacute;mie, les visites aux services de sant & eacute; mentale ont & eacute;t & eacute; consid & eacute;rablement plus faibles que les journ & eacute;es d'& eacute;cole pendant la pand & eacute;mie. Il y a eu moins de visites p & eacute;diatriques en milieu de travail pour trois des quatre ann & eacute;es scolaires o & ugrave; la pand & eacute;mie s'est produite comparativement aux tendances pr & eacute;pand & eacute;miques.ConclusionsLes visites p & eacute;diatriques en salle d'urgence li & eacute;es & agrave; la sant & eacute; mentale & eacute;taient syst & eacute;matiquement plus & eacute;lev & eacute;es les jours scolaires que les jours non scolaires, y compris les jours de fermeture des & eacute;coles en raison du COVID-19. Par rapport aux taux pr & eacute;vus fond & eacute;s sur les tendances pr & eacute;pand & eacute;miques, les visites p & eacute;diatriques en salle d'urgence li & eacute;es & agrave; la sant & eacute; mentale ont diminu & eacute; au cours de trois des quatre ann & eacute;es scolaires pendant la pand & eacute;mie. Nos r & eacute;sultats sugg & egrave;rent un besoin accru de soutien en sant & eacute; mentale dans les services d'urgence pendant les jours scolaires. Ils sugg & egrave;rent & eacute;galement que les DE devraient & ecirc;tre pr & eacute;par & eacute;s aux demandes en sant & eacute; mentale, ainsi qu'aux flamb & eacute;es et aux pand & eacute;mies.