Zanti Sharon, Ma Chenyi
Department of Human Development and Family Studies, Iowa State University, Ames, IA, USA.
School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA, USA.
Psychiatr Q. 2025 Mar;96(1):91-116. doi: 10.1007/s11126-024-10103-9. Epub 2024 Dec 4.
This study reports the prevalence of inpatient, emergency department (ED), and outpatient mental health service usage of children/youth before, during, and after onset of the COVID-19 pandemic in Rhode Island. Additionally, we identify significant changes in usage across these time periods and the prevalence of each service type contingent upon various demographic profiles. This retrospective observational analysis used Rhode Island Medicaid claims to identify the unique children and youth who used inpatient, ED, and outpatient mental health services across three key time periods: pre-onset (March 2019-February 2020); onset (March 2020-February 2021); and post-onset (March 2021-February 2022). We used z-tests to analyze changes in the proportion of children/youth who accessed these services in each period. We examined relationships between demographic characteristics and time period with chi-square tests. Significant decreases in inpatient and ED usage were identified from pre-onset to onset (p < .05). While inpatient nearly returned to pre-pandemic usage in post-onset, ED usage remained lower. Outpatient usage increased significantly leading up to the pandemic but remained at similar levels between pre-onset and post-onset. From pre-onset to post-onset, females grew as a percentage of all inpatient, ED, and outpatient users. Over this same period, the proportion of inpatient users aged 12-18 increased and the proportion of ED and outpatient users aged 19-24 increased. Female usage of mental health services increased significantly, and older children/youth seemed to drive any significant increases. Future public health and disaster preparedness policies should focus on the unique mental health needs of these socially vulnerable groups.
本研究报告了罗德岛州儿童/青少年在新冠疫情爆发前、期间和之后住院、急诊科（ED）及门诊心理健康服务的使用情况。此外，我们还确定了这些时间段内使用情况的显著变化以及不同人口统计学特征下每种服务类型的使用比例。这项回顾性观察分析利用罗德岛州医疗补助索赔数据，确定了在三个关键时间段使用住院、急诊科及门诊心理健康服务的独特儿童和青少年群体：疫情爆发前（2019年3月至2020年2月）；疫情爆发期间（2020年3月至2021年2月）；疫情爆发后（2021年3月至2022年2月）。我们使用z检验分析各时间段内使用这些服务的儿童/青少年比例的变化。我们通过卡方检验研究人口统计学特征与时间段之间的关系。从疫情爆发前到爆发期间，住院和急诊科服务的使用显著减少（p < .05）。虽然住院服务在疫情爆发后几乎恢复到疫情前的使用水平，但急诊科服务的使用仍较低。门诊服务的使用在疫情爆发前显著增加，但在疫情爆发前和爆发后保持在相似水平。从疫情爆发前到爆发后，女性在所有住院、急诊科和门诊服务使用者中的比例有所增加。在同一时期，12 - 18岁住院服务使用者的比例增加，19 - 24岁急诊科和门诊服务使用者的比例增加。女性心理健康服务的使用显著增加，年龄较大的儿童/青少年似乎推动了任何显著的增长。未来的公共卫生和灾难防范政策应关注这些社会弱势群体独特的心理健康需求。
