Mental Health
Change in hospitalization rates for mental health and substance use disorders from before to after the start of the COVID-19 pandemic among Illinois youth, overall and by sex Caitlin Meyer* Caitlin Meyer Julia Howland SJ Doi Abigail Holicky Kristin Rankin
Background: The COVID-19 pandemic exacerbated mental health and substance use (MHSU) disorders among youth, who may be hospitalized if their MHSU needs are not met by outpatient services. This study examined changes in hospitalization rates for MHSU disorders among Illinois youth from before (2018-2019) to after (2021-2022) the start of the COVID-19 pandemic, overall and by sex.
Methods: This study used Illinois hospital discharge data for youth aged 3-17 to examine rates of inpatient MHSU hospitalizations (n=21,992 annually) per 10,000 population, before and after the start of the pandemic. Primary diagnosis codes were used to identify hospitalizations for MHSU disorders and categorize them into disorder subtypes. Rate ratios (RR) and 95% CIs for change over time were estimated using Poisson regression with an interaction term for sex.
Results: MHSU hospitalization rates for Illinois youth decreased significantly from before (96.2 per 10,000) to after (89.5 per 10,000) the start of the pandemic. This masks divergent trends by sex; females’ rates increased (RR=1.05, 95% CI: 1.03-1.07), while males’ rates decreased (RR=0.76, 95% CI: 0.75-0.78; interaction p-value<0.0001). By 2021-2022, females had double the rate of MHSU hospitalizations as males (95% CI: 1.97-2.05). Overall, about three-quarters of youth MHSU hospitalizations were for mood disorders. Despite an overall decrease in MHSU hospitalization rates over time for males, they saw a similar increase as females in hospitalization rates for suicide attempts (overall RR=1.80, 95% CI: 1.58-2.05) and non-suicidal self-injury (RR=1.80, 95% CI: 1.72-1.88).
Conclusion: Nearly 22,000 hospitalizations for MHSU disorders occur each year among Illinois youth, with females bearing the largest burden. Enhanced access to and coordination of outpatient mental health services may reduce these hospitalizations, particularly for suicide attempts and non-suicidal self-injury, which have increased in recent years for both sexes.