Mental health-related presentations to Australian hospital emergency departments by children and young people, before and after the onset of the COVID-19 pandemic: a systematic review and meta-analysis.
15 affiliations
- 1Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia. [email protected].
- 2Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia. [email protected].
- 3Department of Paediatrics, School of Clinical Sciences, Monash University, Clayton, VIC, Australia. [email protected].
- 4Department of Paediatrics, School of Clinical Sciences, Monash University, Clayton, VIC, Australia.
- 5Paediatric Emergency Department, Emergency Service, Monash Medical Centre, Monash Health, Clayton, VIC, Australia.
- 6Emergency Research Group, Murdoch Children's Research Institute, Parkville, VIC, Australia.
- 7School of Psychology, Deakin University, Burwood, VIC, Australia.
- 8School of Psychological Sciences, Monash University, Clayton, VIC, Australia.
- 9Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.
- 10Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia.
- 11Stretton Health Equity, School of Public Health, Adelaide University, Adelaide, SA, Australia.
- 12Port Macquarie Base Hospital, Mid North Coast Health, Port Macquarie, NSW, Australia.
- 13Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- 14Better Health & Care Hub, King's College London, London, UK.
- 15Department of Psychiatry, University of Oxford, Oxford, UK.
Abstract
Introduction
COVID-19 pandemic-related 'lockdowns' (i.e., measures to restrict movements) used to reduce the spread of the COVID-19 virus may have impacted how children and young people (CYP) utilised mental health services. The aim of this review was to synthesise research on COVID-19-related changes in mental health-related emergency department (ED) presentations by CYP in Australia, with reference to lockdown stringency.Methods and analysis
We searched five databases for observational studies published after 31/12/2019 examining ED mental health-related presentations by CYP (aged 0-24 years) before and after onset of COVID-19 lockdowns. Studies were stratified by location and the relative restriction stringency, obtained via the Oxford COVID-19 Government Response Tracker. Region level variation was described, with pooled effects calculated using random effects models.Results
Thirteen studies were included; five from New South Wales, four from Victoria (where lockdowns were most stringent), three from Queensland, and one including multiple Australian states. Outcome definitions and exposure periods were heterogeneous. Pooled estimates showed a moderate-to-large increase in monthly rates of eating disorder presentations, slight-to-moderate increases in overall mental health-related presentations and self-harm and suicide-related presentations, and inconclusive evidence for changes in substance-related and addictive disorder and behavioural/neurodevelopmental disorder-related presentations. Heterogeneity of pooled effects was extremely high (I² = 84.8-99.5%), and the overall certainty of evidence was very low for all outcomes. Findings differed by jurisdiction, but there was insufficient evidence to identify an association between lockdown stringency and ED presentations.Conclusions
CYP ED presentations for eating disorders appear to have increased over the pandemic period, though certainty of evidence was very low. Findings for overall mental health-related presentations and other disorder groups were mixed, with presentations appearing to be lower in Queensland than other states. Future research should prioritise high quality interrupted-time-series analyses of linked and standardised administrative data to better examine the association between specific pandemic policy measures and CYP mental health-related ED utilisation, whilst controlling for potential confounders.Systematic review registration
This review has been registered with PROSPERO (CRD42022342496).
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BibTeX
@article{newberrydupe2026mental,
title = {{Mental health-related presentations to Australian hospital emergency departments by children and young people, before and after the onset of the COVID-19 pandemic: a systematic review and meta-analysis.}},
author = {Jackson Newberry-Dupé and Simon Craig and Glenn Melvin and Kylie King and Yuxi Li and Alexander Campbell and Tom Shore and Timothy Curtis and Rohan Borschmann},
journal = {BMC emergency medicine},
year = {2026},
month = jul,
doi = {10.1186/s12873-026-01700-x},
url = {https://europepmc.org/article/MED/42902195},
note = {CC BY},
}
RIS
TY - JOUR
TI - Mental health-related presentations to Australian hospital emergency departments by children and young people, before and after the onset of the COVID-19 pandemic: a systematic review and meta-analysis.
AU - Jackson Newberry-Dupé
AU - Simon Craig
AU - Glenn Melvin
AU - Kylie King
AU - Yuxi Li
AU - Alexander Campbell
AU - Tom Shore
AU - Timothy Curtis
AU - Rohan Borschmann
PY - 2026
DA - 2026/07/01
JO - BMC emergency medicine
DO - 10.1186/s12873-026-01700-x
UR - https://europepmc.org/article/MED/42902195
AB - Introduction COVID-19 pandemic-related 'lockdowns' (i.e., measures to restrict movements) used to reduce the spread of the COVID-19 virus may have impacted how children and young people (CYP) utilised mental health services. The aim of this review was to synthesise research on COVID-19-related changes in mental health-related emergency department (ED) presentations by CYP in Australia, with reference to lockdown stringency.Methods and analysis We searched five databases for observational studies published after 31/12/2019 examining ED mental health-related presentations by CYP (aged 0-24 years) before and after onset of COVID-19 lockdowns. Studies were stratified by location and the relative restriction stringency, obtained via the Oxford COVID-19 Government Response Tracker. Region level variation was described, with pooled effects calculated using random effects models.Results Thirteen studies were included; five from New South Wales, four from Victoria (where lockdowns were most stringent), three from Queensland, and one including multiple Australian states. Outcome definitions and exposure periods were heterogeneous. Pooled estimates showed a moderate-to-large increase in monthly rates of eating disorder presentations, slight-to-moderate increases in overall mental health-related presentations and self-harm and suicide-related presentations, and inconclusive evidence for changes in substance-related and addictive disorder and behavioural/neurodevelopmental disorder-related presentations. Heterogeneity of pooled effects was extremely high (I² = 84.8-99.5%), and the overall certainty of evidence was very low for all outcomes. Findings differed by jurisdiction, but there was insufficient evidence to identify an association between lockdown stringency and ED presentations.Conclusions CYP ED presentations for eating disorders appear to have increased over the pandemic period, though certainty of evidence was very low. Findings for overall mental health-related presentations and other disorder groups were mixed, with presentations appearing to be lower in Queensland than other states. Future research should prioritise high quality interrupted-time-series analyses of linked and standardised administrative data to better examine the association between specific pandemic policy measures and CYP mental health-related ED utilisation, whilst controlling for potential confounders.Systematic review registration This review has been registered with PROSPERO (CRD42022342496).
SN - 1471-227X
ER -