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Youth Mental Health-Related Emergency Department Visits After Hurricane Helene: A Difference-in-Differences Analysis
Kelsey Herbst1, Maggie M Sugg2, Jennifer D Runkle1
1North Carolina Institute for Climate Studies, North Carolina State University, Asheville, North Carolina.
Purpose:
Extreme weather can disrupt social supports, schooling, and access to behavioral health services, potentially affecting youth mental health. This study examined changes in youth mental health-related emergency department (ED) visits following Hurricane Helene (2024).
Methods:
ED surveillance data from North Carolina (2022-2024) were used to assess mental health-related visits among youth aged 5-26. A difference-in-difference (DID) design compared FEMA-designated disaster counties with nondeclared counties before and after the storm. Multilevel intersectional analyses evaluated risk by sex, race/ethnicity, age, and insurance.
Results:
Anxiety-related ED visits increased in disaster-exposed counties post-Helene (DIDRR = 1.14, 95% confidence interval [CI]: 1.01-1.29), with larger increases among females than males (DIDRR = 1.18, 95% CI: 1.03-1.35). Depression also showed greater relative increases among females (difference-in-difference-in-differencesRR = 1.28, 95% CI: 1.09-1.51). Self-harm visits declined overall (DIDRR = 0.70, 95% CI: 0.52-0.94).
Discussion:
Hurricane Helene was associated with shifts in youth mental health-related ED use, demonstrating the need to strengthen adolescent and young adult behavioral health services in disaster-prone rural communities.
