Lockdown stringency and paediatric self-harm presentations during COVID-19 pandemic: retrospective cohort study

Area of Science:

• Psychiatry
• Public Health
• Epidemiology

Background:

• The COVID-19 pandemic and associated lockdowns significantly impacted public mental health, particularly among children and adolescents.
• Previous research indicated a rise in self-harm and suicide in this demographic, with limited understanding of lockdown stringency's role.

Purpose of the Study:

• To examine how lockdown policy stringency mediated and predicted self-harm and emergency psychiatric presentations in children and adolescents.
• To identify specific factors and demographic groups affected by lockdown measures.

Main Methods:

• A retrospective cohort study analyzed data from 2073 psychiatric emergency presentations.
• Data were collected from 23 hospital catchment areas across ten countries, comparing March-April 2019 with March-April 2020.

Main Results:

• Lockdown stringency mediated a reduction in overall psychiatric emergency presentations (IRRNIE = 0.41) and self-harm presentations (IRRNIE = 0.49).
• Self-harm presentations increased with lockdown stringency for males and looked-after children, and when precipitated by social isolation.
• Conversely, school pressure and peer conflicts were less frequent precipitants, and children from deprived areas were less likely to present during stringent lockdowns.

Conclusions:

• Pandemic lockdowns had differential effects on children and adolescents engaging in self-harm, highlighting potential psychosocial inequalities.
• Enhancing community and remote mental health services is crucial to overcome access barriers, especially for deprived youth.
• Governments should minimize lockdown duration and reduce fear surrounding help-seeking.