The number of young people during the pandemic who sought emergency care and required hospital stays because of 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-investigator at Toronto’s Hospital for Sick Children and senior author of one of the studies, said the findings are likely an underestimate of the true scope.
“For every kid that presents to care, there are probably many more who self-harm at home or who have thoughts of self-harm at home,” said Dr. Saunders, who is also an adjunct scientist at the Institute for Clinical Evaluative Sciences.
One of the studies analyzed data from Ontario; the other looked at national data to get a better understanding of the increased mental health challenges facing adolescents during the pandemic. Both were published Monday in the Canadian Medical Association Journal.
The national study found that overall emergency department visits dropped during the pandemic. But, the number of young people requiring emergency services for suicidal ideation, self-harm and self-poisoning rose, to 6,060 emergency visits per quarter during the pandemic, among 10- to 18-year-olds, from 5,293 visits per quarter before the pandemic.
Hospital admissions for those conditions also increased, to 1,770 admissions per quarter during the pandemic, in that age group, from 1,590 admissions per quarter before the pandemic.
Females aged 10-14 experienced the largest rise in emergency visits and hospital admissions for those mental health conditions, a finding that surprised researchers.
Naveen Poonai, a scientist at Lawson Health Research Institute and a pediatric emergency medicine physician at Children’s Hospital at London Health Sciences Centre, said younger adolescents are often overlooked when it comes to mental health concerns.
“I think primary care providers, whether it be nurses at remote centres or family doctors, probably need to be aware that this demographic, 10-14, is someone that needs to be on their radar,” he said.
The Ontario study, which Dr. Saunders was involved with, used modelling to determine that emergency department visits and hospital admissions for suicidal ideation, self-harm and self-poisoning were higher than expected during the pandemic.
According to the model, there was a 29-per-cent increase in emergency visits during the pandemic and a 72-per-cent increase in hospital admissions.
The expected rate of emergency visits was 0.21 per 1,000 adolescents and rose to 0.27 per 1,000, the study found. The expected rate of hospital admission was 0.43 per 1,000 and rose to 0.74 during the pandemic.
Females were the most likely to seek care for those mental health challenges, with the biggest increase occurring in females aged 10-13.
While the studies, which were based on anonymized health data, can’t point to a definitive cause, the authors say it’s likely a combination of factors, including the upheaval caused by the pandemic, decreased social interaction and fewer available mental health resources.
“Outpatient supports kids rely on were non-existent,” said Dr. Poonai, who is also an associate professor at the Schulich School of Medicine & Dentistry at Western University. “It may be different for adolescents to respond positively to a virtual visit with a mental health specialist.”
He said it’s imperative to improve access to mental health services in schools and ensure plans are in place to maintain access to such supports during the next public health emergency or pandemic.
Elizabeth Saewyc, director of the School of Nursing at the University of British Columbia, said the pandemic led to isolation and upheaval. But, it also caused mass death and illness, which are likely contributors to the problems experienced by young people.
“The overwhelming majority of people who died of COVID were seniors, that means a lot of young peoples’ grandparents passed away,” said Dr. Saewyc, who is also executive director of the Stigma and Resilience Among Vulnerable Youth Centre at UBC.
“I’m not sure that as a society, we have actually grappled with the grief and loss that happened during these years of the pandemic,” she said, “and when we’re not dealing with that grief, we don’t provide opportunities for young people to cope with their own emotions of grief and loss.”