Social isolation and the economic impact of the COVID-19 pandemic and associated mitigation efforts may adversely affect mental health while at the same time cause people to delay or avoid seeking medical care. Researchers used Centers for Disease Control and Prevention data to describe the way U.S. ED visits for mental health conditions, suicide attempts, drug and opioid overdose, and violence changed during the pandemic.

From December 2018 to October 2020, a total of 187,508,065 ED visits were reported, 6,018,318 of which included at least one of the study outcomes: mental health conditions, suicide attempts, all drug overdoses, opioid overdoses, intimate partner violence, and suspected child abuse and neglect.

Total ED visit volume declined soon after COVID-19 mitigation measures were implemented in the United States, beginning on March 16, 2020. Weekly ED visit counts consistently decreased after the declaration of a national emergency on March 13, 2020, whereas ED visit rates for the study outcomes increased. Compared with the same period in 2019, between March 15 and October 10, 2020, median weekly ED visit counts were significantly higher for suicide attempts, all drug overdoses, and opioid overdoses, whereas counts for intimate partner violence and suspected child abuse or neglect were significantly lower. Median rates for the same period were significantly higher in 2020 than in 2019 for all outcomes, except for intimate partner violence. ED visit counts for opioid overdoses showed the most consistent increases.

Limitations of the study, according to the authors, are that the data aren't nationally representative, and rates could be influenced by characteristics of the populations served by the ED or changes in total ED visits during the pandemic.

Their findings suggest, they say, that mental health conditions, suicide attempts, overdoses, and violence remain a concern during the pandemic and that individual-, societal-, and community-level prevention efforts are needed.