The following is a summary of “Acute Healthcare Utilization among Schizophrenia or Related Conditions and Bipolar Disorder Before, During, and After COVID-19,” published in the January 2025 issue of Emergency Medicine by Ornelas et al. 

Trends in Emergency Department (ED) utilization for individuals with schizophrenia and bipolar disorder in California were assessed over a 4-year period, including the COVID-19 pandemic.  

Researchers conducted a retrospective study to assess changes in ED visit rates, demographic characteristics, and admission proportions for Severe Mental Illness (SMI)-related visits before, during, and after the COVID-19 pandemic.  

They analyzed ED utilization among individuals aged 18 or older with SMI from 2018 to 2021, employing the California Department of Health Care Access and Information (HCAI) ED and inpatient discharged databases. The SMI-related visits were identified based on ICD-10 codes. Demographic factors examined included age, sex, race/ethnicity, expected payer, and geographic region.  

The results showed the ED visits rose from 2018 to 2019 but declined in 2020 and 2021, while SMI-related ED visits per 1,00,000 visits elevated from 2019 to 2020 and remained constant in 2021. The highest rates of SMI-related ED utilization were observed in individuals aged 25-44, non-Hispanic Black individuals, and Medicaid beneficiaries. Los Angeles County consistently reported the highest rates across geographic regions.  

Investigators concluded the decline in ED visits during the pandemic, SMI-related visits rose, highlighting the need for mental health resources in EDs, particularly for vulnerable populations such as non-Hispanic Black individuals and those with lower socioeconomic status. 

Source: jem-journal.com/article/S0736-4679(24)00395-0/fulltext