Emergency care for self-harm and suicidal thoughts increased during pandemic among young Canadians

The number of young people during the pandemic who sought emergency care and required hospitalization due to self-harm and suicidal thoughts increased significantly, according to two new studies highlighting the urgent need for accessible mental health care across Canada .

Natasha Saunders, a pediatrician and clinician-scientist at the Hospital for Sick Children in Toronto and lead author of one of the studies, said the findings are likely an underestimate of the true scope.

“For every child who presents for care, there are likely many more who are self-harming at home or thinking about self-harm at home,” said Dr. Saunders, who is also a deputy scientist at the Institute of Clinical Evaluation Sciences. .

One of the studies analyzed data from Ontario; the other examined national data to better understand the growing mental health issues facing adolescents during the pandemic. Both were published Monday in the Canadian Medical Association Journal.

The national study found that overall emergency department visits declined during the pandemic. But the number of young people requiring emergency services for suicidal ideation, self-harm and self-poisoning has increased, from 5,293 visits per quarter before the pandemic to 6,060 visits per quarter among 10 to 18-year-olds. pandemic.

Hospital admissions for these conditions have also increased, to 1,770 admissions per quarter during the pandemic, in this age group, compared to 1,590 admissions per quarter before the pandemic.

Women aged 10 to 14 experienced the largest increase in emergency room visits and hospitalizations for these mental health problems, a finding that surprised researchers.

Naveen Poonai, a scientist at the Lawson Health Research Institute and an emergency pediatrician at the Children’s Hospital at London Health Sciences Centre, said young adolescents are often overlooked when it comes to mental health issues.

“I think primary care providers, whether they’re nurses in remote centers or family doctors, probably need to be aware that this demographic, 10-14 year olds, is someone who needs to be on their radar,” he said.

The Ontario study, in which Dr. Saunders participated, used modeling to determine that emergency department visits and hospitalizations for suicidal ideation, self-harm and self-poisoning were higher than expected during the pandemic.

According to the model, there was a 29 percent increase in emergency room visits during the pandemic and a 72 percent increase in hospital admissions.

The expected rate of emergency room visits was 0.21 per 1,000 adolescents and increased to 0.27 per 1,000, according to the study. The expected hospitalization rate was 0.43 per 1,000 and increased to 0.74 during the pandemic.

Females were most likely to seek care for these mental health issues, with the largest increase occurring among females aged 10 to 13.

Although the studies, based on anonymized health data, cannot point to a definitive cause, the authors say it is likely a combination of factors, including the upheaval caused by the pandemic, decreased interactions social and the reduction in available mental health resources.

“The outpatient services that children rely on were non-existent,” said Dr. Poonai, who is also an associate professor at Western University’s Schulich School of Medicine and Dentistry. “It may be different for adolescents to respond positively to a virtual visit with a mental health specialist. »

He said it was imperative to improve access to mental health services in schools and ensure plans were in place to maintain access to such supports during the next public health emergency or pandemic.

Elizabeth Saewyc, director of the University of British Columbia’s School of Nursing, said the pandemic has led to isolation and upheaval. But it has also caused mass deaths and illnesses, which likely contribute to the problems faced by young people.

“The overwhelming majority of people who died from COVID were older adults, which means many grandparents of young people died,” said Dr. Saewyc, who is also executive director of the Stigma and Resilience Among Vulnerable Youth Center from UBC.

“I’m not sure that as a society we’re really grappling with the grief and loss that has happened during these pandemic years,” she said, “and when we’re not coping To this grief, we are not providing opportunities for young people to deal with their own emotions of grief and loss.