Prevalence and Changes in Usage of Mental Health Services for Rhode Island Children and Youth Before, During, and After Onset of the COVID-19 Pandemic.

Abstract

This study reports the prevalence of inpatient, emergency department (ED), and outpatient mental health service usage of children/youth before, during, and after onset of the COVID-19 pandemic in Rhode Island. Additionally, we identify significant changes in usage across these time periods and the prevalence of each service type contingent upon various demographic profiles. This retrospective observational analysis used Rhode Island Medicaid claims to identify the unique children and youth who used inpatient, ED, and outpatient mental health services across three key time periods: pre-onset (March 2019-February 2020); onset (March 2020-February 2021); and post-onset (March 2021-February 2022). We used z-tests to analyze changes in the proportion of children/youth who accessed these services in each period. We examined relationships between demographic characteristics and time period with chi-square tests. Significant decreases in inpatient and ED usage were identified from pre-onset to onset (p < .05). While inpatient nearly returned to pre-pandemic usage in post-onset, ED usage remained lower. Outpatient usage increased significantly leading up to the pandemic but remained at similar levels between pre-onset and post-onset. From pre-onset to post-onset, females grew as a percentage of all inpatient, ED, and outpatient users. Over this same period, the proportion of inpatient users aged 12-18 increased and the proportion of ED and outpatient users aged 19-24 increased. Female usage of mental health services increased significantly, and older children/youth seemed to drive any significant increases. Future public health and disaster preparedness policies should focus on the unique mental health needs of these socially vulnerable groups.