Changing mental health from disaster to disaster: analysis of emergency psychiatric visits during pandemic and earthquake periods

Social crises deeply affect mental health; however, the effects of different disaster types on emergency psychiatric admissions have not been adequately compared. The pandemic represents a chronic socially mediated stressor, whereas the earthquake constitutes an acute traumatic shock. This study compared emergency psychiatric consultations across three consecutive periods. This was a single-center retrospective observational study. All eligible psychiatric consultations at Sütçü İmam University Faculty of Medicine Hospital during pre-pandemic (January 2019–January 2020), pandemic (February 2020–January 2021), and post-earthquake (February 2023–February 2024) periods were included using a census approach (n = 1,101). Diagnoses were classified by ICD-11. Chi-square and Kruskal-Wallis tests were used. Monthly consultations declined from 46.8 to 17.0 during the pandemic and rebounded to 22.2 post-earthquake (p < 0.001). The pandemic period was associated with higher mood disorder proportions despite fewer consultations. Depressive episode rates rose from 15.8% to 23.5% (p = 0.008); bipolar disorder from 7.9% to 13.1% (p = 0.028). Stress and adjustment disorders peaked at 14.6% in the first six months after the earthquake, declining to 4.1% subsequently (p = 0.001). Self-injurious behaviors showed a non-significant upward trend from 5.9% to 9.7% (p = 0.098). Emergency psychiatric consultations declined during the pandemic and partially rebounded post-earthquake, with diagnostic shifts consistent with each disaster type. Findings reflect service utilization patterns rather than direct community morbidity measures and may not generalize beyond this regional population. Flexible disaster-responsive psychiatric service planning is warranted.