The incidence and admission rate for first-episode psychosis in young people before and during the COVID-19 pandemic in Melbourne, Australia.

OBJECTIVE: The COVID-19 pandemic has had a profound effect on global mental health, with one-third of infected individuals developing a psychiatric or neurological disorder 6 months after infection. The risk of infection and the associated restrictions introduced to reduce the spread of the virus have also impacted help-seeking behaviours. Therefore, this study aimed to determine whether there was a difference during the COVID-19 pandemic in the treated incidence of psychotic disorders and rates of admission to hospital for psychosis (including involuntary admission). METHODS: Incident cases of first-episode psychosis in young people, aged 15 to 24, at an early intervention service in Melbourne from an 8-month period before the pandemic were compared with rates during the pandemic. Hospital admission rates for these periods were also compared. RESULTS: Before the pandemic, the annual incidence of first-episode psychosis was 104.5 cases per 100,000 at-risk population, and during the pandemic it was 121.9 (incidence rate ratio = 1.14, 95% confidence interval = [0.92, 1.42], p = 0.24). Immediately after the implementation of restrictions, there was a non-significant reduction in the treated incidence (incidence rate ratio = 0.80, 95% confidence interval = [0.58, 1.09]), which was followed by a significant increase in the treated incidence in later months (incidence rate ratio = 1.94, 95% confidence interval = [1.52, 2.49]; incidence rate ratio = 1.64, 95% confidence interval = [1.25, 2.16]). Before the pandemic, 37.3% of young people with first-episode psychosis were admitted to hospital, compared to 61.7% during the pandemic (odds ratio = 2.71, 95% confidence interval = [1.73, 4.24]). Concerning the legal status of the admissions, before the pandemic, 27.3% were admitted involuntarily to hospital, compared to 42.5% during the pandemic (odds ratio = 1.97, 95% confidence interval = [1.23, 3.14]). CONCLUSION: There was a mild increase, which did not reach statistical significance, in the overall incidence of first-episode psychosis; however, the pattern of presentations changed significantly, with nearly twice as many cases presenting in the later months of the restrictions. There was a significant increase in both voluntary and involuntary admissions, and the possible explanations for these findings are discussed.

Barriers to attendance at a tertiary hospital's perinatal mortality meeting.

BACKGROUND: Perinatal mortality multi-disciplinary team meetings (PM-MDTMs) offer a forum for multi-disciplinary discussion of poor perinatal outcomes. They ensure a thorough understanding of individual cases and present an important learning opportunity for healthcare professionals (HCPs). Attendance at PM-MDTMs in this tertiary maternity hospital has been low. AIMS: We aimed to identify barriers which may be targeted to improve attendance and engagement. METHODS: An anonymous questionnaire was developed, and all HCPs invited to participate. Demographic data on respondents was collected, as was knowledge of PM-MDTMs, their purpose and relevance to clinical practice, and barriers to attendance at meetings. A total of 78 responses were obtained and analysed. RESULTS: Self-reported understanding of the purpose and format PM-MDTMs was high (84.6% (66/78) and 65.4% (51/78), respectively), while only 50% (39/78) of respondents provided an accurate description of either. Only 50% (39/78) reported having attended a meeting in the hospital, of whom 61.5% (24/39) described the correct meeting. Of these, 37.5% (9/24) reported attending regularly and 70.8% (17/24) found the meeting relevant to their clinical practice. Of the 33.33% (26/78) who reported attending a PM-MDTM in another hospital, 73.1% (19/26) accurately described the meeting, 63.1% (12/19) of these attended regularly, and 100% (19/19) found it relevant. Three main qualitative themes emerged as barriers to attendance and were areas for suggested improvements: workload and staffing levels, meeting logistics, and lack of communication and education regarding PM-MDTMs. CONCLUSIONS: Communication regarding PM-MDTMs and their learning opportunities needs to improve. Lack of engagement is likely compounded by high workloads and staffing levels, but these issues should be surmountable.