Emergency department visits and hospital admissions for suicidal ideation, self-poisoning and self-harm among adolescents in Canada during the COVID-19 pandemic

September 21, 2023admin

Emergency department visits and hospital admissions for suicidal ideation, self-poisoning and self-harm among adolescents in Canada during the COVID-19 pandemic

Abstract

Background: The COVID-19 pandemic had profound effects on the mental wellbeing of adolescents. We sought to evaluate pandemic-related changes in health care use for suicidal ideation, self-poisoning and self-harm.

Methods: We obtained data from the Canadian Institute for Health Information on emergency department visits and hospital admissions from April 2015 to March 2022 among adolescents aged 10–18 years in Canada. We calculated the quarterly percentage of emergency department visits and hospital admissions for a composite outcome comprising suicidal ideation, self-poisoning and self-harm relative to all-cause emergency department visits and hospital admissions. We used interrupted time-series methods to compare changes in levels and trends of these outcomes between the prepandemic (Apr. 1, 2015–Mar. 1, 2020) and pandemic (Apr. 1, 2020–Mar. 31, 2022) periods.

Results: The average quarterly percentage of emergency department visits for suicidal ideation, self-poisoning and self-harm relative to all-cause emergency department visits was 2.30% during the prepandemic period and 3.52% during the pandemic period. The level (0.08%, 95% confidence interval [CI] −0.79% to 0.95%) or trend (0.07% per quarter, 95% CI −0.14% to 0.28%) of this percentage did not change significantly between periods. The average quarterly percentage of hospital admissions for the composite outcome relative to all-cause admissions was 7.18% during the prepandemic period and 8.96% during the pandemic period. This percentage showed no significant change in level (−0.70%, 95% CI −1.90% to 0.50%), but did show a significantly increasing trend (0.36% per quarter; 95% 0.07% to 0.65%) during the pandemic versus prepandemic periods, specifically among females aged 10–14 years (0.76% per quarter, 95% CI 0.22% to 1.30%) and females aged 15–18 years (0.56% per quarter, 95% CI 0.31% to 0.81%).

Interpretation: The quarterly change in the percentage of hospital admissions for suicidal ideation, self-poisoning and self-harm increased among adolescent females in Canada during the first 2 years

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Department Health

September 11, 2023admin

Architect for health department relocation biggest among new St. Clair County ARPA requests

The St. Clair County Health Department building, shown on May 23, 2023, is located at 3415 28th St. Officials are weighing using American Rescue Plan dollars to move the agency's operations from the aging facility to the downtown administration building.

Officials have packed agendas for St. Clair County’s board committee sessions on Thursday, including a few new requests for federal COVID stimulus funds.

And the biggest of those requests — drawing from the county’s remaining American Rescue Plan Act funds — would go toward an architecture firm to relocate the health department.

County administration is recommending the board of commissioners sign off a $557,485 contract with firm NORR to outfit the main administration building, 200 Grand River Ave., in downtown Port Huron once the health agency moves from its 28th Street facility, which Board Chairman Jeff Bohm last month called “by far the worst building the county has” among its aging properties.

“As you can see from the bid tabulation, three of the cost proposals were very close,” Jennifer Posey, administrative services manager, wrote in a memo to the board, citing NORR’s experience with medical facilities and ARPA projects.

“… Upon approval, NORR will work with county staff to prepare drawings, bid documents, and solicit bids for a general contractor for the health department renovation and relocation project.”

In August, county board members agreed to allocate $1 million in ARPA to each of their seven districts with the remaining $9.8 million of the roughly $31 million originally received by the county going toward health department facility needs.

In response to a request for proposals earlier this summer, NORR’s was one of four bids, and though not the cheapest, the highest came in approaching $750,000.

Those bids included the inventory of furnishings, as well as construction and engineering oversight. Under NORR’s bid, the timeline for construction documents was six months. According to Posey’s memo, four firms had attended a walk-through of the existing and new facilities as part of a mandatory step in the bid submission process.

Posey reported that further

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Health Care

August 7, 2023admin

Union says N.S. 811 staff among lowest paid health-care workers in Canada – Halifax

Telehealth associates working for Nova Scotia’s 811 phone line are speaking out through their union about how current wages are leading to difficulties retaining and recruiting workers, as a frequent turnover rate continues to impact the 24/7 health information service.

A release titled “811 workers speak out” from the Nova Scotia Government and General Employees Union (NSGEU), which is the province’s largest union, says 811 workers are amongst the lowest-paid health-care workers in Canada.

The employees, who offer health advice, the transferring of more urgent calls to 911, and assistance in adding residents to the waitlist for a primary healthcare provider, currently make $18.44 an hour. The calculated living wage for Halifax, where the employees are based, is $23.50.

According to the province’s website, 325 patients receive care from an 811 nurse on a regular basis.

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“We are experiencing higher than normal call volumes. It will take longer than usual to respond to your call,” a disclaimer on the service’s website read on Saturday.

Hugh Gillis, first vice president at NSGEU, said telehealth workers are currently under “extreme” pressures due to the position’s around-the-clock nature.

“It is unconscionable that these workers are making less than a living wage,” he said in the release.

There are currently only 17 telehealth associates working in Nova Scotia. They are employed by Emergency Medical Care Inc., which is contracted by the provincial government to operate the service.

“Staffing shortages have been so acute that workers have had to be mandated to work overtime, which is leading to worker fatigue and burn-out, and jeopardizing the service,” NSGEU’s release added.

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In an interview with Global News, Gillis said he continues to hear from workers that it’s becoming increasingly challenging to live in Halifax with their current pay.

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Department Health

June 21, 2023admin

Animal tranquilizer deaths among Georgians are rising, health department data says

While drug overdose deaths from fentanyl continue to grow at an alarming rate, a new disturbing trend is emerging of overdose deaths from an animal tranquilizer that is making its way into the illicit drug supply in Georgia.

Xylazine, also referred to as “Tranq”, is a sedative used by veterinarians but is becoming more prominent due to its use as an adulterant in other drugs such as fentanyl, according to the DEA.

Recent reporting by the Ledger-Enquirer showed a drastic increase in the number of fentanyl overdose deaths in Georgia from 2019 to to 2021.

Now, preliminary numbers from the Georgia Department of Public Health (GDPH) show the trend of overdose deaths from fentanyl continues to rise.

Xylazine-related overdose death have increased 1360% percent in the state between 2020 and 2022. In 2020 there were 15 deaths related to xylazine in the state which has since increased to 219 in 2022, according to the preliminary data from GDPH.

Why is xylazine becoming more prominent?

The DEA says xylazine is used as an adulterant to illicit drugs to possibly increase the amount of profit a dealer can make.

“A kilogram of xylazine powder can be purchased online from Chinese suppliers with common prices ranging from $6-$20 U.S. dollars per kilogram,” according to the DEA’s website.

The drugs death toll has risen across the U.S. but seems to be growing more drastically in the South, according to DEA data. Between 2020 and 2021 the DEA reports the South had a 193% increase to 580 overdose deaths from xylazine. The highest out of any of the four regions.

The CDC reports that “Tranq” is being mixed in with illicit drugs such as cocaine, heroin and fentanyl. Xylazine is not approved for use in people and the CDC says that the animal

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Department Health

May 1, 2023admin

‘Pink eye’ among symptoms of new COVID-19 strain, health officials warn

The Los Angeles County Department of Public Health is warning residents that the newest Omicron strain of COVID-19 may come with some new symptoms.

The U.S. Centers for Disease Control and Prevention predicts the new variant, a strain called XBB.1.16 and known as “Arcturus,” currently accounts for 8% of COVID-19 cases in California and 10% nationwide.

Conjunctivitis, more commonly known as “pink eye,” is the newest possible symptom of this variant of the Coronavirus. So far, the L.A. County Health Department has confirmed three reported cases of the new strain.

“Observational data suggests that people infected with XBB.1.16 may be more likely to experience conjunctivitis as a symptom of their COVID infection, along with more traditional COVID symptoms, such as fever, cough and shortness of breath,” the Health Department said in a statement. “Historically, conjunctivitis was reported in 1 to 3% of COVID-19 cases.”

However, with the limited data available, the Department of Public Health says that it is “too early to know with certainty” if XBB.1.16 is truly associated with higher rates of conjunctivitis.

“Residents should be aware that itchy, watery or red eyes may be a sign of a COVID-19 infection and these symptoms should not be simply dismissed as a result of pollen or seasonal allergies, especially if someone more vulnerable to severe illness could be exposed,” the Health Department said. “The fact that we are seeing new strains, with possibly new and different symptoms, tells us that COVID continues to evolve and the way we think about our protections should reflect what we know.”

Older adults and individuals with underlying health conditions are encouraged to take extra precautions to avoid infection, which include staying up to date on vaccinations, frequent hand washing and staying home when feeling sick.

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Department Health

January 24, 2023admin

Mental health-related emergency department visits and revisits are on the rise among children, study finds

CNN
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Emergency department visits and revisits in children’s hospitals that are related to mental health are “increasing rapidly,” a new study suggests.

Between 2015 and 2020, mental health visits in pediatric emergency departments increased by 8% annually, with about 13% of those patients revisiting within six months, according to the study published Tuesday in the journal JAMA Pediatrics. Whereas, all other emergency department visits increased by 1.5% annually.

Mental health revisits increased by 6.3% annually, but in general, the percentage of mental health visits that had a subsequent revisit remained stable, “which may reflect that the factors associated with revisit did not change substantially during the study period, even as the pediatric mental health crisis worsened,” wrote the researchers, from Children’s Hospital Los Angeles, the University of Southern California and Boston Children’s Hospital.

“However, the significant increase in the raw number of revisits is still concerning,” the researchers added in their study.

The study findings suggest that pediatric mental health emergency department visits and revisits are both climbing, “and identifying patients at high risk of revisit provides an opportunity for tailored interventions to improve mental health care delivery.”

The new study included data on more than 200,000 patients seen at 38 children’s hospitals across the United States between October 1, 2015 and February 29, 2020. The data came from the Pediatric Health Information System, an administrative database of children’s hospitals.

The researchers examined how many visits included diagnoses of mental health disorders or intentional self-harm. They also analyzed mental health revisits, meaning a patient visited the emergency department again within six months of their initial visit.

The ongoing surge in pediatric mental health emergency department visits may be associated with “a combination of factors, including a worsening crisis of pediatric mental illness and shortage of mental health clinicians,”

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Abstract