Objective

To assess the patterns in psychiatric admissions, referrals and suicidal behavior before and during the COVID-19 pandemic.

Methods

This study utilized health records from hospitals and Emergency Medical Services (EMS) covering 46 % of the Danish population (n=2,693,924). In an time-trend study, we compared the number of psychiatric in-patients, referrals to mental health services and suicidal behavior in years prior to the COVID-19 pandemic to levels during the first lockdown (March 11 – May 17, 2020), inter-lockdown period (May 18 – December 15, 2020) and second lockdown (December 16, 2020 – February 28, 2021).

Results

During the pandemic, the rate of psychiatric in-patients declined compared to pre-pandemic levels (RR = 0.95, 95 % CI = 0.94 – 0.96, p < 0.01), with the largest decrease of 19 % observed three weeks into the first lockdown. Referrals to mental health services were not significantly different (RR = 1.01, 95 % CI = 0.92 – 1.10, p = 0.91) during the pandemic; neither was suicidal behavior among hospital contacts (RR = 1.04, 95 % CI = 0.94 – 1.14, p = 0.48) nor EMS contacts (RR = 1.08, 95 % CI = 1.00 – 1.18, p = 0.06). Similar trends were observed across nearly all age groups, sexes and types of mental disorders examined. In the age group <18, an increase in the rate of psychiatric inpatients (RR = 1.11, 95 % CI = 1.07 – 1.15, p < 0.01) was observed during the pandemic; however, this did not exceed the pre-pandemic, upwards trend in psychiatric hospitalizations in the age group <18 (p = 0.78).

Conclusion

The COVID-19 pandemic has been associated with a decrease in psychiatric hospitalizations, while no significant change was observed in referrals to mental health services and suicidal behavior. Psychiatric hospitalizations amongst children and adolescents increased during the pandemic; however, this appears to be a continuation of a pre-pandemic trend.