45.6 The Effect of an Ongoing Pandemic on Mental Health Service Requests

Tarshis, Thomas

Objectives: The aim of this study was to describe the continuing effects of the COVID-19 pandemic on a group of community clinics. Methods: Bay Area Clinical Associates (BACA) serves the majority of the San Francisco Bay Area and provides outpatient and intensive outpatient (IOP) services for youth aged 26 years and under, and their caregivers. BACA employs a multidisciplinary team of mental health practitioners (child and adolescent psychiatrists, psychologists, therapists, and trainees) in 3 different physical locations. Secondary to the pandemic, all services were converted to telehealth beginning in April of 2020. To assess the impact of an extended pandemic on youth mental health, service requests to the agency for the year prior to the pandemic were compared to requests received during the pandemic. In addition, we compared how often the pandemic was mentioned in appointment requests from April 2020 through September 2020 (first 6 months) as compared to October 2020 through March 2021 (next 6 months). Results: In the year prior to the pandemic (April 2019 through March 2020), there was a total of 1757 requests for services, with 648 (36.9%) for IOP services. For the pandemic year (April 2020 through March 2021), there were 2617 new service requests, with 735 (28.1%) for IOP services. Although this represents a 48.9% increase in service requests, the proportion of requests for higher-intensity IOP services was significantly lower (χ2 = 37.6;p < 0.0001). For comparison, the number of requests for services from April 2018 to March 2019 was 1830, with 617 (33.7%) IOP requests. The 4.0% decrease in service requests between 2018 and 2019 suggests that the pandemic was the primary factor for the massive increase in service requests during the first year of the pandemic. During the first 6 months of the pandemic, 94/1067 (8.8%) requests mentioned COVID-19 or its effects vs only 72/1549 (4.7%) during the next 6 months (χ2 = 18.4, p < 0.0001). Conclusions: Almost every news story since April 2020 has discussed mental health. The pandemic appears to be the primary cause for a massive surge in new mental health requests for youth, although specific mention of the pandemic in service requests has decreased. Unfortunately, our already strained mental healthcare system does not have the capacity to correctly address this need. Radical solutions, on many levels, are needed to ensure proper mental health care for our youth. TREAT, CC, ADMIN