TY  - JOUR
AU  - Law, Graham
AU  - Cooper, Rhiannon
AU  - Pirrie, Melissa
AU  - Ferron, Richard
AU  - McLeod, Brent
AU  - Spaight, Robert
AU  - Siriwardena, A Niroshan
AU  - Agarwal, Gina
PY  - 2024
DA  - 2024/5/10
TI  - Ambulance Services Attendance for Mental Health and Overdose Before and During COVID-19 in Canada and the United Kingdom: Interrupted Time Series Study
JO  - JMIR Public Health Surveill
SP  - e46029
VL  - 10
KW  - COVID-19
KW  - mental health
KW  - overdose
KW  - emergency medical services
KW  - administrative data
KW  - Canada
KW  - the United Kingdom
KW  - ambulance
KW  - sex
KW  - age
KW  - lockdown
KW  - pandemic planning
KW  - emergency service
AB  - Background: The COVID-19 pandemic impacted mental health and health care systems worldwide. Objective: This study examined the COVID-19 pandemic’s impact on ambulance attendances for mental health and overdose, comparing similar regions in the United Kingdom and Canada that implemented different public health measures. Methods: An interrupted time series study of ambulance attendances was conducted for mental health and overdose in the United Kingdom (East Midlands region) and Canada (Hamilton and Niagara regions). Data were obtained from 182,497 ambulance attendance records for the study period of December 29, 2019, to August 1, 2020. Negative binomial regressions modeled the count of attendances per week per 100,000 population in the weeks leading up to the lockdown, the week the lockdown was initiated, and the weeks following the lockdown. Stratified analyses were conducted by sex and age. Results: Ambulance attendances for mental health and overdose had very small week-over-week increases prior to lockdown (United Kingdom: incidence rate ratio [IRR] 1.002, 95% CI 1.002-1.003 for mental health). However, substantial changes were observed at the time of lockdown; while there was a statistically significant drop in the rate of overdose attendances in the study regions of both countries (United Kingdom: IRR 0.573, 95% CI 0.518-0.635 and Canada: IRR 0.743, 95% CI 0.602-0.917), the rate of mental health attendances increased in the UK region only (United Kingdom: IRR 1.125, 95% CI 1.031-1.227 and Canada: IRR 0.922, 95% CI 0.794-1.071). Different trends were observed based on sex and age categories within and between study regions. Conclusions: The observed changes in ambulance attendances for mental health and overdose at the time of lockdown differed between the UK and Canada study regions. These results may inform future pandemic planning and further research on the public health measures that may explain observed regional differences. 
SN  - 2369-2960
UR  - https://publichealth.jmir.org/2024/1/e46029
UR  - https://doi.org/10.2196/46029
UR  - http://www.ncbi.nlm.nih.gov/pubmed/38728683
DO  - 10.2196/46029
ID  - info:doi/10.2196/46029
ER  -