During the second year of the Covid-19 pandemic, the mental health crisis among adolescents got so severe that the number of emergency room visits for teenage girls in the United States increased by at least 22%, according to a recent study published in JAMA Psychiatry.
“The pandemic exacerbated stressors among youth, including social isolation, school disruptions, and parental unemployment, and rates of depression and anxiety have doubled since the start of the pandemic. In 2021, 20% of high school students seriously considered suicide, and 9% attempted suicide,” the researchers wrote.
To delve into how severe the mental health crisis got during 2021, the team closely studied private health insurance claims that were submitted from March 2019 to February 2022. The researchers analyzed a sample of 4.1 million children and adolescents. Fifty one percent of them were male and 41% were aged 13 years to 17 years old. They identified 88,665 visits to emergency departments. Out of that 20.9% of them were admitted in hospitals because of depression.
“There was a striking 76% increase in prolonged boarding,” the researchers noted. While 26.1% were female, only 15.9% of the admitted patients were male. On average, they spent nine nights in the hospital. “Only 14% of pediatric hospitalists reported that youth boarding at their institutions received medication management and 18% that they received psychotherapy. Parents of boarding youth frequently likened the environment to incarceration and experienced significant distress during boarding. Clinicians often find it morally distressing to care for boarding youth,” they added.
Overhage and colleagues further observed a 7% increase in the number of youth who visited emergency departments due to poor mental health. But among teenage girls, that number shot up to 22%. “Multiple factors likely contribute to females’ increase in mental distress including higher pandemic-related stress, more pandemic-related disruptions to school, and emotional abuse in the home,” the researchers wrote in the JAMA study.
“This may explain why the increase in ED visits for females was primarily driven by suicidal ideation, suicide attempt, and self-harm. There was also a doubling in the fraction of adolescent females with an ED visit for an eating disorder. This may be a continuation of a prepandemic trend of worsening eating disorder symptoms,” they added. “Some have hypothesized that the worsening of symptoms during the pandemic was due to more screen time and seeing oneself on camera. However, if this was the mechanism, then we would have expected a reduction in ED visits with a return to in-person learning, which we do not observe.”
In a press release, lead author of the study, Lindsay Overhage said: “One surprising and concerning finding was that the increase in ED visits was largely driven by girls who came to the hospital for conditions such as suicidal thoughts or plans, suicide attempts, and self-harm. It’s critical that we do all we can to prevent these serious illnesses and to treat those who are suffering.”
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