Suicide or self-injury and depressive disorders continued to account for a majority of acute mental health care encounters in US children’s hospitals after COVID-19- related school closures, according to a study published in Psychiatric Services. Bonnie T. Zima, MD, MPH, and colleagues conducted a retrospective, cross-sectional cohort study using the Pediatric Health Information System database to assess percent changes in ED discharges and hospitalizations among children aged 3-17 in 44 US hospitals in 2020 (after statewide COVID-19-related school closure orders) compared with 2019. Data were included for 2.65 million total encounters in 2020. The decrease in mental health ED discharges was smaller than the decline in ED discharges and hospitalizations for primary general medical disorders (−24.8% vs −49.1%), and mental health hospitalizations decreased less (−8.0% vs −26.8%) in 2020. More than 50% of acute mental healthcare encounters before and after the statewide school closures were suicide attempt or self-injury and depressive disorders. By fall 2020, there was a 41.7% increase in mental health hospitalizations for suicide attempt or self-injury, with increases of 43.8% and 49.2% among adolescents and girls, respectively.

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