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Hospitalizations and emergency department visits for pediatric mental health and self-harm concerns remained high 3 years into the COVID-19 pandemic.

Monthly rates of pediatric hospitalizations and emergency department (ED) visits related to mental health (MH) rose higher than expected only in the second year after the onset of the COVID-19 pandemic, according to a study published in JAMA Network Open.

“However, rates of MH-related hospitalizations and ED visits among girls aged 12 to 17 years and among those diagnosed with behavioral syndromes associated with physiological disturbances, particularly eating and sleep disorders, persistently exceeded expected rates 3 years after the pandemic onset,” wrote study author Zaba Valtuille, MSc, of Robert Debré University Hospital, and colleagues.

To shed light on changes in pediatric hospital resource use related to MH long after the COVID-19 pandemic onset, the study team investigated national hospital data in France between January 1, 2016, and May 31, 2023. They looked particularly at hospitalizations and ED visits for MH and self-harm among children aged 6 to 17 years.

The analysis included 583,244 hospitalizations (81.4% for MH and 18.6% for self-harm) and 432,725 ED visits (79.9% for MH and 20.1% for self-harm).

“Before the pandemic, an increasing trend in all monthly rates, except that of MH-related hospitalizations, was observed,” investigators wrote. “After an immediate decrease in hospitalization and ED visit rates during the initial pandemic period (March 1 to May 31, 2020), trends increased in the first 2 years following the pandemic onset and decreased thereafter.”

Uptick in Hospitalizations, ED Visits Continue Years Into Pandemic

With respective increases of 6% and 5%, rates of MH-related hospitalizations and ED visits were higher than expected in the second year after the pandemic’s start.

Hospitalizations and ED visits for behavioral syndromes associated with physiologic disturbances—primarily eating and sleep disorders—consistently exceeded expected rates, with third-year increases of 29% in hospitalizations and 26% in ED visits.

“Likewise, rates of SH [self-harm]-related  hospitalizations and ED visits, specifically among girls aged 12 to 17 years, persistently exceeded expected rates after the pandemic onset,” the researchers wrote.

In the third year after the pandemic onset, self-harm hospitalizations increased 29% and self-harm ED visits increased 43%, according to the study results.

“Future research should focus on identifying and addressing persistent stressors in children,” the researchers wrote. “Longer-term monitoring of the use of acute hospital resources related to MH should be pursued to guide allocation of health care resources and to tailor preventive interventions.”