Impact of the COVID-19 pandemic on long-term trends in psychiatric service utilisation at an accident and emergency department in Hong Kong.

OBJECTIVES: To describe trends in psychiatric service utilisation at the accident and emergency department (AED) of the Prince of Wales Hospital, Hong Kong, between July 2017 and June 2024. METHODS: This retrospective observational study reviewed medical records of patients who received psychiatric services in the AED of the Prince of Wales Hospital, Hong Kong, between July 2017 and June 2024 encompassing periods before the pandemic (July 2017 to December 2019), during the pandemic (January 2020 to September 2022), and after the pandemic (October 2022 to June 2024). The 'window period' (May 2021 to December 2021), during which no community outbreak was reported, was excluded from the pandemic period. Data collected included patient demographics, psychiatric diagnoses, and management plans. Trends in psychiatric service utilisation during the study period were analysed. RESULTS: In total, 7441 AED psychiatric consultations (61.1% women) were included in the analysis. The median patient age significantly increased from 45 years in 2017 to 49 years in 2024 (p = 0.007). There was an increasing trend in AED psychiatric service utilisation. Attendance counts decreased during the first two quarters of 2020 (beginning of the pandemic) and substantially surged in 2021 during the window period, followed by a sharp decline in 2022 during the fifth wave driven by the Omicron variant and then rebounded at the beginning of 2023, and the upward trend continued. Daily attendance counts significantly increased from 2017 to 2024 among patients with major neurocognitive disorders, neurodevelopmental disorders, and disorders specifically associated with stress. Discharge to the community was the most common management plan. CONCLUSION: The COVID-19 pandemic disrupted access to healthcare services in patients with psychiatric illnesses. Demand for AED psychiatric services rebounded after the pandemic. Between 2017 and 2024, the overall patient age increased, and service utilisation increased among patients with major neurocognitive disorders and neurodevelopmental disorders.