The Impact of the COVID-19 Pandemic on Psychiatric Emergency Service Volume and Hospital Admissions

Background: During the COVID-19 pandemic, there have been an increasing number of emergency department visits for behavioral health reasons, even as overall emergency department volumes have decreased. The impact of the pandemic and related public health interventions on specialized psychiatric emergency services has not been described. These services provide high-intensity care for severely ill patients who are likely to be homeless and underserved. Objective: We describe the change in total volume and psychiatric hospitaliza-tion rates among three psychiatric emergency services across the United States. Methods: Changes in volumes and hospitalization were assessed for statistical signifi-cance using a seasonal autoregressive integrated moving average with exogenous factors model from January 2018 to December 2020. Results: The pandemic's impact on volumes and hospitalization varied by site. In Denver (CO), there was a statistically significant 9% decrease in overall volumes, although an 18% increase in hospitalizations was not significant. In New York City (NY), there was a significant 7% decrease in volumes as well as a significant 6% decrease in hos-pitalizations. In Portland (OR), volumes decreased by 4% and hospitalizations increased by 6% although differences did not reach statistical significance. Conclusions: There has been a decrease in volume at these services after the pandemic, but there are sub-stantial variations in the magnitude of change and de-mand for hospitalization by region. These findings suggest a need to understand where patients in crisis are seeking care and how systems of care must adapt to changing utilization in the pandemic era. (Journal of the Academy of Consultation-Liaison Psy-chiatry 2021; 62:588-594)