Mental Health ED Visits Are Less Elastic Than Overall ED Visits

A recent study published in JAMA Network Open concluded that mental health emergency department visits are less elastic than overall emergency department (ED) visits. Using data from before and during the COVID-19 pandemic, researchers found a smaller decline in mental health ED visits than in general ED visits.

Researchers used data from the CDC National Syndromic Surveillance Program on mental health ED visits from approximately 71% of facilities in the United States. The data was sectioned by week and included 10 regions covered by the Department of Health and Human Services (HHS): Boston, New York, Philadelphia, Atlanta, Chicago, Dallas, Kansas City, Denver, San Francisco, and Seattle.

Mental Health ED visits between January 1, 2019, and December 31, 2021, were evaluated, including visits with an acute mental health crisis and where mental health conditions were coded in the discharge diagnosis.

The CDC data set included 1,570 mental health ED visits. Throughout the research period, there were statistically significant declines in mental and non-mental health-related ED visits. After the onset of the pandemic, total ED visits declined by 39%. Comparatively, mental health ED visits only fell by 23%.

Beyond general percentages, researchers noted a change in the proportion of mental health ED visits compared to all ED visits. For example, in 2019, mental health ED visits accounted for 8% of all ED visits. In 2020, at the height of the pandemic, the proportion of mental health ED visits increased to 9%.

As COVID-19 vaccines rolled out and the risks associated with seeking care declined, overall ED visits rebounded more than mental health visits, reducing the proportion of mental health ED visits to 7%.

Based on this data, researchers emphasized the importance of adequate mental health services in acute and outpatient settings, noting that mental health issues must be addressed even in times of crisis.

While additional data from the remaining 29% of US healthcare facilities may provide further insight, the investigators imply that those with non-mental health conditions are more likely to adapt to public health emergencies than those with mental health conditions.