Publication date: Jul 21, 2026
COVID-19 produced a detrimental effect on mental health that could not be appropriately addressed due to a reduced accessibility of healthcare services, as patients with socioeconomic vulnerabilities faced the largest barriers in accessing healthcare during the pandemic. This study aimed to investigate emergency department (ED) accesses with a psychiatric diagnosis before and after COVID-19, with a specific focus on the role of socioeconomic factors. This is a multicentre longitudinal retrospective study that involves a population-based open cohort of residents and National Health Service (NHS)beneficiaries aged ≥ 10, enrolled in three large Italian areas from 1 January 2018 to 31 December 2021 (n = 5,159,363). The primary outcome of interest was the First Mental Health Emergency Access (FMHEA); sex, age, deprivation level, citizenship and groups of diagnosis were considered as covariates. Crude incidence rates were calculated comparing the two time periods (pre- and post-COVID-19) by each covariate. In the context of interrupted time series (ITS), incidence rate ratios (IRR) of FMHEAs with 95%CI were estimated via an ITS analysis using a step-change negative binomial model. Temporal trend of FMHEAs was investigated through an ITS analysis on their monthly numbers. During follow-up, 56,762 FMHEAs were observed. The multivariate analysis showed that before COVID-19, the rate of FMHEA was higher among the highly deprived (IRR: 1. 28; 95%CI:1. 22. -1. 35 for highest vs lowest deprivation level), females, people aged ≤24 and ≥85 and immigrants. A significant interaction between the COVID-19 period and deprivation level was found: the probability of reduced FMHEA increased with the deprivation level. The greater impact of COVID-19 was found in the central age classes resulting in a reduction in the differences in FMHEA rates by age in the post-Covid-19 period. COVID-19 reduced incidence rates of ED accesses, but increased socioeconomic inequalities in the use of ED for mental health disorders.
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Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 |
| disease | MESH | emergency |
| disease | MESH | psychiatric diagnosis |
| disease | MESH | NHS |
| disease | MESH | Long Covid |
| disease | MESH | ATS |
| disease | MESH | ARS |
| pathway | REACTOME | Reproduction |
| drug | DRUGBANK | Trestolone |
| disease | MESH | death |
| disease | MESH | ICD |
| disease | MESH | included |
| disease | MESH | injury |
| disease | MESH | Delirium |
| disease | MESH | Confusion |
| disease | MESH | Dissociation |
| disease | MESH | Eating Disorders |
| disease | MESH | Anxiety Disorders |
| disease | MESH | Sleep Disorders |
| disease | MESH | Mood Disorders |
| disease | MESH | Personality Disorders |
| disease | MESH | Schizoaffective Disorder |
| disease | MESH | Adjustment Disorders |