Psychiatric emergencies and suicide attempts before and during COVID-19 confinement in Spain.

The study was carried out in the only psychiatric emergency department in the province of Lérida, at the University Hospital Santa María de Lérida.

Clearly, the COVID-19 pandemic has had a significant impact on the mental health of the population in the different phases. The most acute period in which the health emergency prevailed with high uncertainty regarding the etiopathogenesis of the virus and its consequences overlapped with the first state of alarm. In Spain the confinement, from March 14 to June 21, was particularly stressful. This study aimed to examine differences in psychiatric emergency visits for psychiatric reasons before and during confinement in the only psychiatric emergency department in the province of Lleida, which covers 431,183 inhabitants. Aimed to develop research, 1,599 emergency department visits were compared in terms of their characteristics before (June 13 to March 13, 2020) and during (March 14 to June 21, 2020) the first confinement in the province of Lérida. Data were obtained from the electronic medical record. The information collected included sociodemographic variables, reason for consultation, previous diagnosis and characteristics of suicidal ideation and attempts, including history of previous suicidal behavior, suicidal method, days of stay in general emergency or medical-surgical unit (somatic lethality) and suicide reattempts at 6-month follow-up. Our results revealed that, before confinement, there was an average of 11.2 psychiatric emergencies per day compared to 9.2 psychiatric emergencies per day during confinement with 20% of these being for anxiety reasons. Regarding suicidal behavior, prior to confinement, there was an average of 0.9 suicide attempts per day prior to confinement versus 0.7 attempts per day during confinement. Regarding suicidal behavior relapse after this initial assessment, we observed that prior to confinement 27% relapsed at 6 months and during confinement this figure was 30%. Regarding continuity of care after evaluation in the psychiatric emergency department, 64% of those treated prior to confinement attended the outpatient visit, while during confinement only 38.5% attended.

These data are openly worrying because, despite the opportunities of telemedicine, it was not possible to ensure the follow-up of users. Like other research groups, we observed a decrease in the number psychiatric emergency visits, as well as a lower frequency of patients with suicidal behavior during the first confinement in Spain, which occurred during the initial months of the pandemic. However, this decrease was only temporary, as there has been evidence of an upturn in the number of urgent care visits subsequently and a higher number of suicides. Ensuring access to mental health care in times of crisis is crucial for the population.

Original paper: Irigoyen-Otiñano, M., Porras-Segovia, A., Vega-Sánchez, D., Arenas-Pijoan, L., Agraz-Bota, M., Torterolo, G., Sánchez-Cazalilla, M., Fuentes-Casany, D., Adrados-Pérez, M., & Puigdevall-Ruestes, M. (2023). Psychiatric Emergencies and Suicide Attempts Before and During COVID-19 Lockdown in Spain. Crisis, 10.1027/0227-5910/a000896. Advance online publication. https://doi.org/10.1027/0227-5910/a000896