Substance Abuse and Mental Health: Exploring the Effects on Pediatric Trauma in the COVID-19 Pandemic Era

Background Substance abuse and mental health diagnoses among pediatric patients with trauma have been rising. The COVID-19 pandemic introduced social isolation and stressors that may have increased risky behaviors and worsened mental health in youth. Objective The overall objective was to evaluate changes in the proportion of pediatric patients with trauma with mental health and/or substance abuse comorbidities before, during, and after the COVID-19 pandemic. Methods A retrospective, single-center cohort study was conducted using trauma registry data (2018-2023) for patients meeting National Trauma Data Standard criteria with documented mental health or substance abuse disorders. Data were analyzed across three periods: pre-pandemic (2018-2019), pandemic (2020-2021), and post-pandemic (2022-2023). Variables included demographics, injury mechanism and severity, toxicology results, admission status, and hospital course. Results The proportion of patients with comorbidities increased from 1.11% pre-pandemic to 4.99% during and 8.99% post-pandemic. Most were white, non-Hispanic male patients, with blunt trauma as the predominant mechanism. The patients during the pandemic period had the highest mean injury severity score (6.0), the longest ICU stays (4.3 days), the longest ventilator use (5.0 days), and the greatest need for surgery (50.6%). Conclusion The proportion of pediatric patients with trauma and mental health or substance abuse disorders rose nearly nine-fold during and after the pandemic, indicating a lasting impact of pandemic-related disruptions. These patients demonstrated greater injury severity and hospital resource use, underscoring the need for continued mental health screening and intervention in pediatric trauma care.