Factors Affecting Self-Harm- or Violence-Related Urgent Psychiatric Consultation During the COVID-19 Pandemic in Taiwan

Chung-Chen Yeh,1– 3,* Yu-Tung Lee,4,* Cheng-Yu Chien,5,6 Po-Cheng Chen,3,7 Jian-Hong Chen,3,8,9 Chun-Hao Liu3,10 1Department of Emergency Medicine, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan; 2Department of Emergency Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan; 3College of Medicine, Chang Gung University, Taoyuan City, Taiwan; 4Department of Psychiatry, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan; 5Graduate Institute of Management, Chang Gung University, Taoyuan City, Taiwan; 6Department of Emergency Medicine, Ton-Yen General Hospital, Hsinchu County, Taiwan; 7Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan; 8Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung City, Taiwan; 9National Taiwan Sport University, Taoyuan City, Taiwan; 10Department of Child & Adolescent Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan*These authors contributed equally to this workCorrespondence: Chun-Hao Liu, Department of Child & Adolescent Psychiatry, Chang Gung Memorial Hospital, Linkou, No. 5, Fu-Hsin St., Gueishan District, Taoyuan City, 333, Taiwan, Tel +886-3-3281200 ext 2439, Fax +886-3-3280267, Email abucastor@hotmail.comPurpose: People’s health-care-seeking behaviors considerably changed during the COVID-19 pandemic. This study evaluated the changes in self-harm- and violence-related urgent psychiatric consultation (UPC) in the emergency department (ED) during different stages of the pandemic and at different levels of hospitals.Patients and Methods: We recruited patients who received UPC during the baseline (2019), peak (2020), and slack (2021) periods of the same time window (calendar weeks 4– 18) during the COVID-19 pandemic. Demographic data such as age, sex, and referral type (by the police/emergency medical system) were also recorded.Results: We found female gender and younger age associated with higher risk of self-harm-related UPCs, whereas patients visiting regional hospitals, male patients, and patients referred by the policy/emergency medical system, had a higher risk of violence-related UPCs. After adjustment, the different pandemic stages were not significantly associated with self-harm- or violence-related UPCs.Conclusion: Patient’s demographic data, but not the pandemic itself, may be responsible for the changes in self-harm- and violence-related UPCs during the pandemic.Keywords: COVID-19, emergency department, psychiatric consultation, self-harm, violence