The impact of the COVID-19 pandemic on children and adolescent mental health inpatient service use in England: An interrupted time-series analysis of national patient records
Background: During the initial phases of the COVID 19 pandemic children and young people (CYP) faced significant restrictions. The virus and mitigation approaches significantly impacted how health services could function, and be safely delivered. Aims: To investigate the impact of COVID-19 lockdowns on CYP psychiatric admission trends during lockdowns 1 (started 23/032020) and 2 (started 05/11 2020) of the COVID 19 pandemic in England. Methods: Routinely collected, retrospective, English administrative data looking at psychiatric hospital admissions, length of stay and patient demographic factors were analysed using an interrupted time series analysis (ITSA) to estimate the impact of COVID 19 lockdowns 1 and 2 on service use trends. We analysed data of 6,250 CYP (up to 18 years of age) using ordinary least squares (OLS) regression analysis with Newey-West standard errors to handle autocorrelation and heteroscedasticity. Results: Psychiatric hospital admissions for CYP significantly fell during lockdown 1, and then fell further even during lockdown 2. A greater proportion of admissions during lockdown were out of area or to independent sector units. During lockdown, the average age of CYP admitted was older and a greater proportion were female. There was also a significant increase in the proportion of looked-after children and CYP from the most socioeconomically deprived areas admitted during lockdown 2. Conclusions: During both lockdowns, fewer CYP had psychiatric admissions. The subsequent rise in admissions for more socioeconomically deprived CYP and looked after children suggests these CYP may have been disproportionately affected by the pandemic, or overlooked during earlier phases
