School Closings Due to Pandemic Affected the Mental Health of Teen Girls

Suicide or self-injury and depressive disorders were the primary mental health reasons children received emergency department (ED) or hospital inpatient care after state-wide school closures were enacted during the first part of the COVID-19 pandemic. This finding is published in the journal Psychiatric Services.

COVID-19 Pandemic — A New Thorn In Mental Health Care

The COVID-19 pandemic created an unprecedented burden on children and on a health care system that is challenged to meet their needs.

This new study will help us understand how pandemic-related social isolation, limited access to school-based mental health resources, family stress, and numerous other factors are impacting our children. Importantly, it will give us direction in our efforts to mitigate the harmful effects.

In this large retrospective study, researchers examined the percent changes in ED discharges and hospital stays between 2019 and 2020, matching 36-week time intervals corresponding to spring through fall of both years and capturing data for children ages 3 to 17.

Following governor executive orders for state-wide school closure in 26 states, at a time when parents avoided bringing their child to hospitals for fear of exposure to the coronavirus — ED visits and hospitalizations for both acute general medical and mental health care abruptly decreased.

However, this trend only persisted for acute care encounters for general medical conditions, not for child and adolescent mental health disorders.

Closing the School Doors Showed Way for Isolation

They found that the declines in ED and hospital discharges for primary psychiatric diagnoses after state-wide school closure orders were two to three times less than those for general medical conditions.

Hospitalizations for suicide, psychosis, and eating disorders substantially increased after state-wide COVID-19 school closure orders. By fall 2020, hospitalizations for suicide or self-injury rose by 41.7%, with a 43.8% and 49.2% rise among teens and girls.

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The research used the Pediatric Health Information System database and included 2,658,474 encounters and 1,876,715 children. Of the total number of encounters, 39.3% involved children who were white, 23.7% Black, 26.6% Hispanic, and 10.4% of encounters involved children from other racial or ethnic groups.

“Our findings identify drivers of the disproportionate rise in acute mental health care encounters that occurred during the time intervals corresponding to the abrupt shift to remote learning, followed by summer vacation and the start of a new school year,” said Zima, professor-in-residence, UCLA Child and Adolescent Psychiatry.

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Contrary to the authors’ expectations, acute care mental health encounters did not disproportionately rise for children with disorders such as autism, developmental disorders, and attention-deficit/hyperactivity disorder — those who most likely would be eligible for special education resources.

The rise in hospitalizations suggests concerns related to imminent safety, severe weight loss, or worsening of psychotic symptoms selectively drove mental health hospitalizations following statewide school closure orders.

Adolescent females were particularly vulnerable, with a disproportionate rise in encounters with suicide or self-injury in the summer and fall of 2020. Hospitalizations for suicide or self-injury in the fall of 2020 increased by more than 40% for 12- to 17-year-olds — and almost 50% for females.

This study is an eye-opener to focus the attention on the pandemic’s effects on children’s mental well-being, which is often neglected.

Source-Medindia