The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index.
Trends in US Emergency Department Visits for Mental Health, Overdose, and Violence Outcomes Before and During the COVID-19 Pandemic
Open accessAbstract
Importance: The coronavirus disease 2019 (COVID-19) pandemic, associated mitigation measures, and social and economic impacts may affect mental health, suicidal behavior, substance use, and violence. Objective: To examine changes in US emergency department (ED) visits for mental health conditions (MHCs), suicide attempts (SAs), overdose (OD), and violence outcomes during the COVID-19 pandemic. Design, Setting, and Participants: This cross-sectional study used data from the Centers for Disease Control and Prevention's National Syndromic Surveillance Program to examine national changes in ED visits for MHCs, SAs, ODs, and violence from December 30, 2018, to October 10, 2020 (before and during the COVID-19 pandemic). The National Syndromic Surveillance Program captures approximately 70% of US ED visits from more than 3500 EDs that cover 48 states and Washington, DC. Main Outcomes and Measures: Outcome measures were MHCs, SAs, all drug ODs, opioid ODs, intimate partner violence (IPV), and suspected child abuse and neglect (SCAN) ED visit counts and rates. Weekly ED visit counts and rates were computed overall and stratified by sex. Results: From December 30, 2018, to October 10, 2020, a total of 187 508 065 total ED visits (53.6% female and 46.1% male) were captured; 6 018 318 included at least 1 study outcome (visits not mutually exclusive). Total ED visit volume decreased after COVID-19 mitigation measures were implemented in the US beginning on March 16, 2020. Weekly ED visit counts for all 6 outcomes decreased between March 8 and 28, 2020 (March 8: MHCs = 42 903, SAs = 5212, all ODs = 14 543, opioid ODs = 4752, IPV = 444, and SCAN = 1090; March 28: MHCs = 17 574, SAs = 4241, all ODs = 12 399, opioid ODs = 4306, IPV = 347, and SCAN = 487). Conversely, ED visit rates increased beginning the week of March 22 to 28, 2020. When the median ED visit counts between March 15 and October 10, 2020, were compared with the same period in 2019, the 2020 counts were significantly higher for SAs (n = 4940 vs 4656, P = .02), all ODs (n = 15 604 vs 13 371, P < .001), and opioid ODs (n = 5502 vs 4168, P < .001); counts were significantly lower for IPV ED visits (n = 442 vs 484, P < .001) and SCAN ED visits (n = 884 vs 1038, P < .001). Median rates during the same period were significantly higher in 2020 compared with 2019 for all outcomes except IPV. Conclusions and Relevance: These findings suggest that ED care seeking shifts during a pandemic, underscoring the need to integrate mental health, substance use, and violence screening and prevention services into response activities during public health crises.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“visits to an emergency department for mental health consults and suspected child abuse, risk factor for potential suicide attempts, also increased in 2020 compared with 2019 (10).”
From Suspected Suicide Attempts by Self-Poisoning Among Persons Aged 10–19 Years During the COVID-19 Pandemic — United States, 2020–2022 (2023) · cites this paper as [10]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“However, the consistency of these findings with those in other published studies highlights the association of the COVID-19 pandemic with harmful effects on youth mental health”
From Suspected Suicide Attempts by Self-Poisoning Among Persons Aged 10–19 Years During the COVID-19 Pandemic — United States, 2020–2022 (2023) · cites this paper as [10]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“average ED visit rates for mental health concerns and suspected child abuse and neglect, risk factors for suicide attempts, also increased in 2020 compared with 2019 (5)”
From Emergency Department Visits for Suspected Suicide Attempts Among Persons Aged 12–25 Years Before and During the COVID-19 Pandemic — United States, January 2019–May 2021 (2021) · cites this paper as [5]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“This report expands upon previous work highlighting increases in ED visits for suspected suicide attempts earlier in the pandemic among all persons (5) and suggests that these trends persisted among young persons as the pandemic progressed.”
In the citing paper
“Of them, we have identified common thematic recommendations for preventing suicidal deaths and suicidal attempts, and those were; 1) Develop a systematic suicide screening process and increase the suicide risk screening [23, 25, 28, 30, 37].”
From Impact of the COVID-19 pandemic on suicidal attempts and death rates: a systematic review (2022) · cites this paper as [35]
In the citing paper
“Recommendations for preventing suicide/suicide attempts were provided in nine studies [23, 25, 27, 28, 30, 31, 33, 35, 37].”
From Impact of the COVID-19 pandemic on suicidal attempts and death rates: a systematic review (2022) · cites this paper as [35]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
The Ecology of Human Development: Experiments by Nature and Design
Bronfenbrenner, U. (1979) · Harvard University Press eBooks · doi:10.4159/9780674028845 · Cited by 26,084
The world report on violence and health
Krug, E. G., Mercy, J. A., Dahlberg, L. L., & Zwi, A. B. (2002) · The Lancet · doi:10.1016/s0140-6736(02)11133-0 · Cited by 9,110
The Ecology of Human Development
Bronfenbrenner, U. (1981) · Harvard University Press eBooks · doi:10.2307/j.ctv26071r6 · Cited by 8,168
Holmes, E. A., O'Connor, R. C., Perry, V. H., Tracey, I., Wessely, S., Arseneault, L., Ballard, C., Christensen, H., Cohen Silver, R., Everall, I., et al. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30168-1 · Cited by 5,715
When Work Disappears: The World of the New Urban Poor.
Scott, D. M., & Wilson, W. J. (1998) · African American Review · doi:10.2307/3042249 · Cited by 3,616
Czeisler, M. É., Lane, R. I., Petrosky, E., Wiley, J. F., Christensen, A., Njai, R., Weaver, M. D., Robbins, R., Facer-Childs, E. R., Barger, L. K., et al. (2020) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6932a1 · Cited by 2,686
Self-citationGalea, S., Merchant, R. M., & Lurie, N. (2020) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2020.1562 · Cited by 2,089
Suicide risk and prevention during the COVID-19 pandemic
Gunnell, D., Appleby, L., Arensman, E., Hawton, K., John, A., Kapur, N., Khan, M., O'Connor, R. C., Pirkis, J., Appleby, L., et al. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30171-1 · Cited by 1,513
Post-traumatic stress disorder following disasters: a systematic review
Neria, Y., Nandi, A., & Galea, S. (2008) · Psychological Medicine · doi:10.1017/s0033291707001353 · Cited by 1,429
When work disappears: the world of the new urban poor
(1997) · Choice Reviews Online · doi:10.5860/choice.34-4179 · Cited by 1,279
Stress and psychological distress among SARS survivors 1 year after the outbreak
Lee, A. M., Wong, J. G., McAlonan, G. M., Cheung, V., Cheung, C., Sham, P. C., Chu, C.-M., Wong, P.-C., Tsang, K. W., & Chua, S. E. (2007) · The Canadian Journal of Psychiatry · doi:10.1177/070674370705200405 · Cited by 1,195
Coronavirus disease 2019 (COVID-19) and mental health for children and adolescents
Golberstein, E., Wen, H., & Miller, B. F. (2020) · JAMA Pediatrics · doi:10.1001/jamapediatrics.2020.1456 · Cited by 1,140
Hartnett, K. P., Kite-Powell, A., DeVies, J., Coletta, M. A., Boehmer, T. K., Adjemian, J., Gundlapalli, A. V., & Practice, N. S. S. P. C. O. (2020) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6923e1 · Cited by 1,139
Self-citationPsychological distress and loneliness reported by US adults in 2018 and April 2020
McGinty, E. E., Presskreischer, R., Han, H., & Barry, C. L. (2020) · JAMA · doi:10.1001/jama.2020.9740 · Cited by 978
Opioid crisis: no easy fix to its social and economic determinants
Dasgupta, N., Beletsky, L., & Ciccarone, D. (2018) · American Journal of Public Health · doi:10.2105/ajph.2017.304187 · Cited by 923
How neighborhoods influence child maltreatment: A review of the literature and alternative pathways
Coulton, C. J., Crampton, D., Irwin, M., Spilsbury, J. C., & Korbin, J. E. (2007) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2007.03.023 · Cited by 730
(2020) · RePEc: Research Papers in Economics · Cited by 475
Increase in state suicide rates in the USA during economic recession
Reeves, A., Stuckler, D., McKee, M., Gunnell, D., Chang, S.-S., & Basu, S. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61910-2 · Cited by 347
National Center for Injury Prevention and Control (U.S.). Division of Violence Prevention., Fortson, B. L., Klevens, J., Merrick, M. T., Gilbert, L. K., & Alexander, S. P. (2016) · doi:10.15620/cdc.38864 · Cited by 334
Home is not always a haven: The domestic violence crisis amid the COVID-19 pandemic.
Kofman, Y. B., & Garfin, D. R. (2020) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0000866 · Cited by 319
Suicide and violence prevention: Parent education in the emergency department
Kruesi, M. J. P., Grossman, J., Pennington, J. M., Woodward, P. J., Duda, D., & Hirsch, J. G. (1999) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199903000-00010 · Cited by 251
Preventing suicide : a technical package of policies, programs, and practice
Stone, D. M., Holland, K., Holland, B., Crosby, A. E., Davis, S. P., & Wilkins, N. J. (2017) · doi:10.15620/cdc.44275 · Cited by 221
Self-citationThe Impact of Neighborhoods on Intimate Partner Violence and Victimization
Pinchevsky, G. M., & Wright, E. M. (2012) · Trauma Violence & Abuse · doi:10.1177/1524838012445641 · Cited by 213
Reducing Fatal Opioid Overdose: Prevention, Treatment and Harm Reduction Strategies.
Hawk, K. F., Vaca, F. E., & D’Onofrio, G. (2015) · PubMed Central · Cited by 203
Grattan, L. M., Roberts, S. M., Mahan, W. T., McLaughlin, P. K., Otwell, W. S., & Morris, J. G. (2011) · Environmental Health Perspectives · doi:10.1289/ehp.1002915 · Cited by 191
Trump, D. J. (2020) · Cited by 175
Impact of Business Cycles on US Suicide Rates, 1928–2007
Luo, F., Florence, C., Quispe‐Agnoli, M., Ouyang, L., & Crosby, A. E. (2011) · American Journal of Public Health · doi:10.2105/ajph.2010.300010 · Cited by 156
Lethal Means Counseling for Parents of Youth Seeking Emergency Care for Suicidality
Runyan, C. W., Becker, A., Brandspigel, S., Barber, C. W., Trudeau, A., & Novins, D. K. (2016) · Western Journal of Emergency Medicine · doi:10.5811/westjem.2015.11.28590 · Cited by 113
Basile, K. C., DeGue, S. A., Jones, K., Freire, K. E., Dills, J., Smith, S. G., & Raiford, J. L. (2016) · doi:10.15620/cdc.39126 · Cited by 74
Yoon, P. W., Ising, A., & Gunn, J. E. (2017) · Public Health Reports · doi:10.1177/0033354917708995 · Cited by 47
Ansari, S., & Boyle, A. A. (2016) · European Journal of Emergency Medicine · doi:10.1097/mej.0000000000000416 · Cited by 22
Flagged first, then by citations
Research works printed but not linked: 6
- World Health Organization, 1980, International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)
- World Health Organization, 2015, International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM).
- The White House, 2020, The President's Coronavirus Guidelines for America: 30 Days to Slow the Spread.
- Centers for Disease Control and Prevention, 2020, COVID-19 Community Intervention and At-Risk Task Force, Monitoring and Evaluation Team & CDC, Center for State, Tribal, Local, and Territorial Support, Public Health Law Program. State, Territorial, and County COVID-19 Orders and Proclamations for Individuals to Stay Home, May 31, 2020
- Centers for Disease Control and Prevention, 2018, Evidence-Based Strategies for Preventing Opioid Overdose: What's Working in the United States
- Niolon, 2017, Eliminating Intimate Partner Violence Across the Lifespan: A Technical Package to Prevent Intimate Partner Violence, Including Teen Dating Violence
Cited by
Sorted by citations
Mental Health Surveillance Among Children — United States, 2013–2019
Bitsko, R. H., Claussen, A. H., Lichstein, J., Black, L. I., Jones, S. E., Danielson, M. L., Hoenig, J. M., Davis Jack, S. P., Brody, D. J., Gyawali, S., et al. (2022) · MMWR Supplements · doi:10.15585/mmwr.su7102a1 · Cited by 1,723
Self-citationYard, E., Radhakrishnan, L., Ballesteros, M. F., Sheppard, M., Gates, A., Stein, Z., Hartnett, K., Kite-Powell, A., Rodgers, L., Adjemian, J., et al. (2021) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm7024e1 · Cited by 617
“In addition, average ED visit rates for mental health concerns and suspected child abuse and neglect, risk factors for suicide attempts, also increased in 2020 compared with 2019 (5), potentially contributing to increases in”
BackgroundResultSelf-citationHow COVID-19 shaped mental health: from infection to pandemic effects
Penninx, B. W. J. H., Benros, M. E., Klein, R. S., & Vinkers, C. H. (2022) · Nature Medicine · doi:10.1038/s41591-022-02028-2 · Cited by 480
Mental health concerns during the COVID-19 pandemic as revealed by helpline calls
Brülhart, M., Klotzbücher, V., Lalive, R., & Reich, S. K. (2021) · Nature · doi:10.1038/s41586-021-04099-6 · Cited by 183
Friedman, J. R., & Akre, S. (2021) · American Journal of Public Health · doi:10.2105/ajph.2021.306256 · Cited by 168
Metadata
- Authors
- Holland, K. M., Jones, C., Vivolo-Kantor, A. M., Idaikkadar, N., Zwald, M., Hoots, B., Yard, E., D’Inverno, A., Swedo, E., Chen, M. S., Petrosky, E., Board, A., Martinez, P., Stone, D. M., Law, R., Coletta, M. A., Adjemian, J., Thomas, C., Puddy, R. W., Peacock, G., Dowling, N. F., & Houry, D.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Corresponding author
- Holland, Kristin M.
- ORCID
- Venue
- JAMA Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2021-04-01
- Volume
- 78
- Issue
- 4
- Pages
- 372
- ISSN
- 2168-622X (ISSN-L)
- PMC
- PMC7859873
- OpenAlex
- W3126297842
- Cited by
- 578
- References
- 31
- Citations by year
- 2026: 29 · 2025: 32 · 2024: 88 · 2023: 129 · 2022: 166 · 2021: 133
- FWCI
- 88.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Keywords
- COVID-19 pandemic, emergency department visits, mental illness, suicide attempts, drug overdose, opioid overdose, intimate partner violence, child abuse, COVID-19 mitigation measures, sex differences, substance use, violence, access to mental health care, United States, 2020-2021 pandemic
- MeSH terms
- COVID-19, SARS-CoV-2, Adult, Mental Disorders, Emergency Service, Hospital, Female, Humans, Male, Mental Health, Patient Acceptance of Health Care, Suicide, Attempted, United States, Violence, Outcome Assessment, Health Care, Epidemiological Monitoring, Drug Overdose
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
