Skip to main content
. Author manuscript; available in PMC: 2022 Apr 1.
Published in final edited form as: JAMA Psychiatry. 2022 May 1;79(5):475–485. doi: 10.1001/jamapsychiatry.2022.0164

Table 2.

Changes in MH-Related ED Visits for Adults Aged 18 to 64 Years During Selected Periods During the COVID-19 Pandemic, by Race and Ethnicity, US, December 27, 2020, to August 14, 2021a,b

After Delta variant onset, index period: July 18-August 14,2021 After a COVID-19 case peak, index period: February 14, 2021-March 13, 2021
Index period compared with MH during the COVID-19 pandemic, prior to Delta variant period (April 18-May 15, 2021) Index period compared with MH during a COVID-19 case peak (December 27, 2020-January 23, 2021)
Race and ethnicity Total ED visit counts for MH, No. ED visits for MH per 100 000ED visitsc Change in ED counts for MH, %d Visit ratio (95% CI)e Total ED visit counts for MH, No. ED visits for MH per 100 000 ED visitsc Change in ED counts for MH, %d Visit ratio (95% CI)d
All MH
American Indian orAlaska Native 218 7428 −8.3 0.84 (0.70–1.00) 241 10 871 6.2 1.14 (0.96–1.35)
Asian 251 6406 12.0 0.98 (0.82–1.16) 227 7809 4.0 1.15 (0.96–1.37)
Black 3693 6318 1.7 0.89 (0.85–0.93) 3489 8050 3.0 1.06 (1.01–1.10)
Hispanic 2792 6026 −0.5 0.89 (0.84–0.93) 2783 7946 −0.3 1.05 (1.00–1.11)
Native Hawaiian or Other Pacific Islander 25 4744 −16.0 0.78 (0.46–1.31) 31 6798 0.0 0.98 (0.61–1.58)
White 13 226 9792 2.2 0.87 (0.86–0.90) 12 388 12 301 2.0 1.05 (1.02–1.07)
Anxiety disorders
American Indian or Alaska Native 121 4123 9.9 1.01 (0.78–1.30) 118 5323 5.1 1.12 (0.87–1.45)
Asian 137 3497 18.3 1.05 (0.82–1.34) 113 3887 8.0 1.20 (0.92–1.56)
Black 1450 2481 1.3 0.89 (0.83–0.96) 1328 3064 5.0 1.08 (1.00–1.16)
Hispanic 1604 3462 −0.9 0.88 (0.83–0.95) 1518 4334 −5.1 1.00 (0.94–1.07)
Native Hawaiian or Other Pacific Islander 12 2277 −33.3 0.68 (0.32–1.41) 13 2851 −38.5 0.71 (0.35–1.43)
White 7157 5299 0.4 0.86 (0.83–0.89) 6655 6608 0.1 1.03 (1.00–1.06)
Depressive disorders
American Indian or Alaska Native 72 2453 −6.9 0.85 (0.62–1.17) 91 4105 9.9 1.18 (0.88–1.59)
Asian 83 2118 20.5 1.08 (0.79–1.49) 79 2718 26.6 1.50 (1.08–2.10)
Black 1025 1754 −1.1 0.87 (0.80–0.95) 1001 2310 3.6 1.06 (0.97–1.16)
Hispanic 773 1668 −0.9 0.88 (0.80–0.98) 815 2327 4.1 1.10 (1.00–1.21)
Native Hawaiian or Other Pacific Islander NAf NAf NAf NAf NAf NAf NAf NAf
White 4273 3164 −2.2 0.84 (0.80–0.87) 4386 4355 4.3 1.07 (1.03–1.12)
Bipolar disorders
American Indian or Alaska Native 13 443 −30.8 0.70 (0.34–1.43) 15 677 40.0 1.78 (0.78–4.05)
Asian 22 562 −13.6 0.76 (0.43–1.34) 22 757 4.6 1.16 (0.64–2.10)
Black 482 825 −3.1 0.85 (0.75–0.96) 477 1101 4.2 1.07 (0.94–1.21)
Hispanic 218 471 −6.0 0.84 (0.70–1.01) 251 717 24.3 1.39 (1.15–1.68)
Native Hawaiian or Other Pacific Islander NAf NAf NAf NAf NAf NAf NAf NAf
White 1738 1287 7.1 0.92 (0.86–0.99) 1547 1536 0.1 1.03 (0.96–1.10)
Schizophrenia spectrum disorders
American Indian or Alaska Native 21 716 −23.8 0.73 (0.41–1.30) 22 992 0 1.07 (0.59–1.92)
Asian 22 562 18.2 1.05 (0.56–1.96) 19 654 −31.6 0.84 (0.46–1.52)
Black 727 1244 4.7 0.92 (0.83–1.02) 714 1647 −6.0 0.97 (0.87–1.07)
Hispanic 243 524 −2.9 0.87 (0.73–1.03) 296 845 6.4 1.13 (0.96–1.33)
Native Hawaiian or Other Pacific Islander NAf NAf NAf NAf NAf NAf NAf NAf
White 1022 757 4.5 0.90 (0.82–0.98) 1011 1004 11.5 1.16 (1.06–1.27)
Trauma- and stressor-related disorders
American Indian orAlaska Native 24 818 −25.0 0.73 (0.43–1.24) 33 1488 42.4 1.85 (1.06–3.25)
Asian 17 434 11.8 0.97 (0.49–1.95) 10 344 −10.0 1.00 (0.43–2.36)
Black 206 352 −5.8 0.83 (0.69–1.00) 214 494 14.0 1.19 (0.98–1.45)
Hispanic 178 384 −7.9 0.83 (0.68–1.01) 184 525 −6.0 0.99 (0.81–1.22)
Native Hawaiian or Other Pacific Islander NAf NAf NAf NAf NAf NAf NAf NAf
White 796 589 −5.5 0.81 (0.74–0.89) 792 786 6.2 1.10 (0.99–1.21)

Abbreviations: ED, emergency department; MH, mental health; NA, not available.

a

The National Syndromic Surveillance Program collects free-text reason for visit (chief complaint), discharge diagnosis, and patient demographic details. Diagnosis information is collected using International Classification of Diseases, Ninth Revision, Clinical Modification codes; International Classification of Diseases, Tenth Revision, Clinical Modification codes; and Systematized Nomenclature of Medicine codes. ED visits associated with any MH-related visit and specific mental disorders were identified by querying ED visits data from the National Syndromic Surveillance Program using keyword syndromes developed by the US Centers for Disease Control and Prevention in partnership with state and local health departments (eTable 1 in the Supplement).

b

To reduce artifactual effects from changes in reporting patterns, analyses examining trends in MH-related ED visits by race and ethnicity were restricted to facilities with a coefficient of variation of 40 or less and mean weekly discharge diagnosis of 75% or more from January to August 2021 and were further limited to facilities with 75% or more complete data for the combined race and ethnicity fields.

c

Rate of ED visits for MH outcome equaled the number of ED visits for MH outcome in the period of interest divided by the number of total ED visits in the time period of interest for the subpopulation of interest multiplied by 100 000.

d

Percentage change in visits was calculated as the difference in total visits between the index period and the comparison period divided by the total visits during the comparison period multiplied by 100.

e

Visit ratios equaled the proportion ED visits for MH outcome during the index period divided by the proportion of ED visits for MH outcome during the comparison period.

f

If index period ED visits counts for a particular race and ethnicity were less than 10, cell volumes were suppressed and are listed as NA.