Trends in emergency department visits for mental health disorders in France, 2017–2024: a nationwide observational study

In the aftermath of the COVID-19 pandemic, general Emergency Departments (ED) recorded sustained increases in psychiatric presentations. Analysing ED presentations for psychiatric conditions over time, by sex and age group, may provide insights into underlying trends and guide strategies to optimise mental health care amid considerable strain on healthcare services. This retrospective study aims to describe the temporal evolution of ED visits related to psychiatric disorders from 2017 to 2024, and to analyse changes following the COVID-19 pandemic. We used the French national database of ED visits, recording every visit daily from all public and private hospitals authorised to provide emergency care. We only considered visits of patients aged 16 years and older. Data were aggregated by sex, age groups, and diagnostic categories. We modelled weekly counts of ED visits over the study period using a Seasonal AutoRegressive Integrated Moving Average (SARIMA) to investigate temporal evolution and to estimate counterfactual data for the post-COVID period, based on the pre-COVID trends. ED visits related to psychiatric conditions rose steadily after 2021, while their proportion relative to all ED visits remained stable at around 3% over the entire study period. However, this apparent stability masked several shifts in the profile of patients presenting to the ED for mental health disorders, with more urgent care seeking among women and patients aged 16–24 years, and for schizophrenia, mood disorders, and behavioural and emotional disorders. Using counterfactual prediction methods, we observed that ED visits for mental health disorders were higher than expected under a no-COVID scenario (+ 252 ED visits per week; 2.8% [1.7 ; 4.1]), almost entirely driven by women (+ 249 ED visits per week; +6.4% [4.6 ; 7.3]). A major change was also observed among those age 16–24 years, with a 16.1% [14.4; 17.8] higher level in the post-pandemic period. Regarding psychiatric conditions, a higher level was observed for most disorders, except those related to psychoactive substance use (-261 visits per week; −8.6% [− 10.3; −6.9]). In France, demand for urgent psychiatric care appears to be increasing, especially among specific patient populations.