THE IMPACT OF COVID-19 ON COMMUNITY CYMHS

Abstract

Background: In the beginning of the COVID-19 pandemic, several papers suggested that the impact on mental health (MH) would be largest in children and youth and in individuals who were already affected by mental disorders. Given that the public child and youth mental health services (CYMHS) in Australia were already overburdened, it is important to gain knowledge on the exact impact to estimate resources required to meet the needs of children and youth with complex and severe mental disorders. Objectives: To explore the effect of the COVID-19 pandemic on: (1) the symptoms experienced by children already in treatment and factors influencing these and (2) the demand for MH care in the child and youth mental health service (CYMHS), specifically in the community and the emergency department (ED). Methods: The COVID-19 Mental Health Survey - modified from the National Institute of Mental Health developed CRISIS Survey - was disseminated to parents and caregivers of children and adolescents under treatment at community CYMHS (Brisbane, Australia) between July and November 2020 throughout different stages of COVID-19-related restrictions. Parents of 110 children and adolescents participated. We further compared numbers of ED presentations and referrals to CYMHS between 2018, 2019 and 2020. Findings: The most reported children's symptoms were sadness (46%), anxiety (60%), a lack of focus (61%), a lack of joy in their usual activities (38%) and a reduction in sleep (42%). Children who attended school (partially) remotely for some of the days had a significantly higher risk of having the most reported symptoms, as well as children who completed the survey in later stages of the lockdown with further easing of restrictions. We further saw a marked month-by-month increase in demand in the community MH needs for child and adolescent psychiatry demonstrated by a steady rise in referrals and acute presentations (at most a 50% increase) when comparing January to December 2019 with the data of January to December 2020. Conclusion: This explorative study shows long-lasting impacts for this vulnerable patient group, even after the relatively mild course of COVID-19 and related restrictions as experienced in Brisbane. Unfortunately, the number of children who were accepted for treatment in CYMHS did not increase as the number of staff did not increase, indicating a large mismatch between needs and resources.L6383264572022-07-01 <br />