Seasonal Surge for Mental Health Demand in Emergency Departments

Objective: To analyze emergency department (ED) mental health presentations over a 7-year period to estimate the timing and magnitude of the seasonal effect across Australia.

Methods: We analyzed data collected by the Australian Institute of Health and Welfare (AIHW) from 2014–2015 to 2020–2021, which included all public hospital ED presentations in Australia that received a mental health diagnosis per the Australian Modification of ICD-10. The data were divided into 4 sequential quarters (Q1 = July–September, Q2 = October–December, Q3 = January–March, Q4 = April–June) and analyzed by sex and age (youth: 18–24 years, adult: 25–64 years, and older adult: > 65 years). Regression analysis was used to assess seasonal variation.

Results: On average, mental health ED presentations were 9% higher in October–December than April–June, which had the lowest rates of mental health ED presentations for males and females. The peak continued into January–March, most prominently for females. Seasonality was evident in the 18–24 and 25–64 age groups. There were increased ED psychiatry presentations in October–December of 14.4% (males) and 9% (females) in the group aged 18–24, as well as increases of 10.3% (males) and 10.1% (females) in those aged 25–64. In January–March, there was an increase in presentations for females of 7% (aged 18–24) and 10.3% (aged 25–64). For adults aged > 65, there were increased presentations in July–September compared to April–June of 4.9% (males) and 3.9% (females).

Conclusions: We found strong, statistically significant peaks in mental health ED presentations in spring and summer. Mental health services need to plan for significantly higher ED mental health demand during these seasons. Further research is required to estimate the size of the mental health seasonal effect in acute hospital settings.