1445 Assessing the impact the Covid-19 pandemic has had on children’s mental health presentations to a tertiary children’s emergency department

BackgroundThe Covid-19 pandemic has caused widespread disruption of children and young people’s (CYP) lives. The lasting effects of the pandemic have not truly been assessed. We have seen a rise in severity of mental health presentations and a trend in a younger age group presenting to the emergency department (ED).ObjectivesTo describe the change in mental health presentations during each UK lockdown period.MethodsSingle centre retrospective chart review, in a tertiary children’s hospital. All mental health presentations were included during each of the UK lockdown periods;First lockdown (23.03.2020 - 04.07.2020), Second lockdown (05.11.2020 - 02.12.2020) and Third lockdown (05.01.2021 - 08.03.2021). Data was taken from a previous comparative search of coding and clinical key words which identified all CYP presenting with a mental health issue.Electronic patient notes were used to gain data on coded diagnosis, sex, age and ethnicity. The same lockdown dates were used to compare these presentations to presentations in 2017, 2018 and 2019.ResultsThere has been a rise in mental health presentations during the second and third lockdown periods compared to to the last four years. Pre-Covid 2017 Pre-Covid 2018 Pre-Covid 2019 During Covid-19 First lockdown (1) 130 185 214 146 Second lockdown (2) 54 62 58 76 Third lockdown (3) 61 108 151 200 The most common coded diagnosis during Covid-19 was Depressive disorder (69, 16.3%), Anxiety (49, 11.6%), Paracetamol overdose (86, 20.3%) and Eating Disorder (33, 7.8%). There were also diagnoses seen that did not present in 2017 -2019 e.g. Suicidal thoughts (20, 4.7%) and mixed overdose (30, 7.1%).The common age group seen in all three Covid lockdown periods was 15 years (Lockdown 1–44%, Lockdown 2–34.2%, Lockdown 3–25%). There were more females affected (Lockdown 1–80.1%, Lockdown 2–81.5%, Lockdown 3–74.5%) and White British were affected more (Lockdown 1–80.1%, Lockdown 2–81.5%, Lockdown 3–74.5%).Throughout the last four years during the same three periods the similarity in age, sex and ethnicity has also been seen. The most common diagnoses seen during the last four years included paracetamol overdose and depressive disorder which have risen with each year:2019 (Paracetamol OD 20.1%, Depressive disorder 21%, eating disorder 6.1%, anxiety 15.6%)2018 (paracetamol OD 18.3%, depressive disorder 27%, eating disorder 2.8%, anxiety 10.7%)2017 (paracetamol OD 9.7%, depressive disorder 10.2%, eating disorder 2.4%, anxiety 4%)ConclusionsThe lower mental health presentations seen during the first lockdown compared to the last four years can be explained by the effect the start of the pandemic had in the UK population. The ‘stay at home’ message may have provided valuable parental support to those CYP who would have otherwise presented during that period with a mental health issue. However, with the ongoing changes during the last year surrounding financial and educational uncertainty, the numbers have risen. Recent epidemiological models have predicted a spike in Covid-19 in July, this will impact the mental health numbers that emergency departments will see. Adequate provision should be put in place to support the CYP now and in the future.