Park Song-Yi, Kim Sun-Hyu
Department of Emergency Medicine, Dong-A University College of Medicine, Dong-A University Hospital, Busan 48114, Korea.
Department of Emergency Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan 44033, Korea.
Healthcare (Basel). 2022 Apr 13;10(4):716. doi: 10.3390/healthcare10040716.
The COVID-19 pandemic and its resulting social restrictions have significant implications for mental health. The objective of this study was to determine the monthly trends and types of patients experiencing a mental health crisis (MHC) who used emergency medical services (EMSs) before and during the COVID-19 pandemic. A retrospective observational study was conducted using EMS data. During the study period, 8577 patients used EMSs for MHCs. EMS dispatches for MHCs and suicide completion after the COVID-19 pandemic were decreased by 12.4% and 12.7%, respectively, compared to those before the COVID-19 pandemic. Segmented regression analysis found that the number of patients per month was 6.79 before the COVID-19 pandemic. The number decreased to 4.52 patients per month during the COVID-19 pandemic, although the decrease was not statistically significant. The monthly number of patients experiencing an MHC decreased during strict social distancing measures but increased during relaxed social distancing measures. The percentage of hanging increased from 14.20% before the COVID-19 pandemic to 14.30% (p = 0.03) during the COVID-19 pandemic, whereas the percentages of jumping (from 15.55% to 15.28%, p = 0.01) and self-harm by smoke (from 4.59% to 3.84%, p < 0.001) during the COVID-19 pandemic were decreased compared to those before COVID-19. However, the effect size for the above findings was small (below 0.20). More than 25% of the patients experiencing an MHC who used EMSs refused to transfer to the ED over both study periods (26.49% in the pre-COVID-19 period and 28.53% in the COVID-19 period). The COVID-19 pandemic and social restrictions seemed to have some effects on the use of EMSs by MHC patients. Hanging is mainly performed indoors and is not found easily if social distancing persists, and a patient experiencing an MHC who refuses to be transferred could potentially attempt suicide. Subsequent studies should be performed to determine whether these findings are temporary during the COVID-19 pandemic or whether they will show different aspects after the COVID-19 pandemic.
新冠疫情及其导致的社会限制对心理健康有重大影响。本研究的目的是确定在新冠疫情之前和期间使用紧急医疗服务（EMS）的心理健康危机（MHC）患者的月度趋势和类型。使用EMS数据进行了一项回顾性观察研究。在研究期间，8577名患者因MHC使用了EMS。与新冠疫情之前相比，新冠疫情之后因MHC的EMS调度和自杀完成率分别下降了12.4%和12.7%。分段回归分析发现，新冠疫情之前每月的患者数量为6.79人。在新冠疫情期间，每月患者数量降至4.52人，尽管下降没有统计学意义。在严格的社交距离措施期间，每月经历MHC的患者数量减少，但在宽松的社交距离措施期间增加。上吊的比例从新冠疫情之前的14.20%增加到新冠疫情期间的14.30%（p = 0.03），而在新冠疫情期间跳楼（从15.55%降至15.28%，p = 0.01）和吸烟自残（从4.59%降至3.84%，p < 0.001）的比例与新冠疫情之前相比有所下降。然而，上述发现的效应量较小（低于0.20）。在两个研究期间，超过25%因MHC使用EMS的患者拒绝转至急诊科（新冠疫情之前为26.49%，新冠疫情期间为28.53%）。新冠疫情和社会限制似乎对MHC患者使用EMS有一些影响。上吊主要在室内进行，如果社交距离持续存在则不容易被发现，而拒绝转诊的MHC患者可能会有自杀企图。后续研究应确定这些发现是新冠疫情期间的暂时现象，还是在新冠疫情之后会呈现不同的情况。
