Impact of COVID-19 on psychiatric assessment in emergency and outpatient settings measured using electronic health records

Victor M. Castro; Roy H Perlis

More generally, our results demonstrate the potential for application of electronic health records to enable near-real-time understanding of how psychiatric assessments, and potentially individual symptoms, change across health systems. Given abundant evidence from China that the COVID-19 pandemic has had substantial impact on psychiatric symptoms among health care workers 45 and more broadly 6 , and emerging survey data from the UK and US 78 , one might expect to see an increase rather than decrease in such symptom presentations in Boston-area hospitals. Indeed, if visits were not markedly diminished, it seems likely such a change would be observed. However, the present results suggest that, if such an increase in symptoms exists, it is not driving more psychiatric visits. As such, efforts to provide more accessible psychiatric care during the acute phase of the COVID-19 pandemic become particularly important: symptoms are likely to be increasing, while access is objectively decreasing. The accelerating shift to telemedicine may help to address this need 17 . However, given the apparent magnitude of the decrease, other strategies are also urgently needed to ensure that another consequence of the broadening pandemic is not neglect of new or worsening psychiatric symptoms. Table 1 . Sociodemographic summary of patients seen from 1/2/2020-3/25/2020. Counts and percentages are total number of notes by visit setting.