4.2 Clinical Applicability
Before the pandemic only one patient with a pre-existing psychiatric condition was identified compared to 16 after. Subsequently, there was increased demand for inpatient mental health treatment post-injury reflecting an additional impact on mental health services experienced post-lockdown.
Our centre experienced an increase in the number of PNIs post-lockdown and an increase in the number of surgical procedures on PNIs (see Table 2 and Table 3) representing a rise in demand for trauma and surgical services. This contrasts with the experience of other centres such as King’s College London which recorded a decrease in penetrating trauma (a decrease of 35%) (8).
Our centre experienced an increase in the proportion of DSHs post lockdown. DSH is a concerning feature as it often precedes suicide attempts (9). People with pre-existing mental illness are classified as being at increased risk due to social distancing measures, (9,10). The long-term effects of the COVID-19 pandemic on mental health are unknown, but studies of previous pandemics found that for people with prior psychiatric diagnoses the negative effects of isolation could be observed at least 4-6 months after quarantine (11).
Our centre saw a 16-fold increase in the proportion of patients with pre-existing mental health disorder with DSH post lock-down perhaps reflective of this increase in risk to mental health and DSH posed by the COVID-19 pandemic.