COVID-19’s mental health toll on children continues, stressing acute-care settings

Data shows increase in depression, anxiety, self-harm and eating disorders

New Jersey youth seeking hospital care for mental health diagnoses such as depression, anxiety, self-harm and eating disorders remains elevated well beyond pre-pandemic levels, according to a new data brief from the New Jersey Hospital Association.

The increase, first identified in 2020 emergency department data, continued in NJHA’s analysis of 2021 hospital visits. The new analysis by NJHA’s Center for Health Analytics, Research and Transformation, or CHART, includes hospital inpatient data for the first time, showing that the degree of mental health illness among this age group is driving an increase in inpatient hospital admissions.

“We are witnessing the extended impact of the pandemic years on the demand for mental health services,” NJHA CEO and President Cathy Bennett said. “The emergency department is very often the first point of contact for youths in mental health crisis, but now, we see that journey continuing into inpatient care in our hospitals. This is an important early indicator of the need for better access to mental health services for New Jersey’s youth.”

Need help?

Recognizing the challenges this presents to many New Jersey families, NJHA has produced a reference sheet for parents of children struggling with mental health issues. Called “What Should I Do?,” the resource aims to simplify the process for parents seeking help by identifying the various settings for mental health care, questions to ask and links to services. It’s available online at and as a printable PDF for families to save as a resource.

NJHA’s analysis reviewed hospital claims data for both emergency department visits and inpatient admissions for ages 12 to 17 over a five-year period spanning 2017 through 2021. CHART’s analysis looked specifically at changes from 2019 — the last pre-pandemic year — and the most recently available data for 2021. While some of the emergency room data stabilized — albeit at elevated levels — from 2020 and 2021, the hospitalizations continued to increase in 2021 in four areas:

  • Among the four conditions studied, depression was the most common diagnosis among those ages 12 to 17, both in the ED and in the inpatient setting. The proportion of depression-related hospitalizations increased 25%, from a rate of 244 per 1,000 in 2019 to 304 per 1,000 in 2021.
  • The proportion of self-harm cases resulting in a hospital admission among ages 12-17 jumped 95% from 2019 (a rate of 288 per 1,000) to 2021 (596 per 1,000).
  • Inpatient admissions for youth ages 12 to 17 with a diagnosis for anxiety increased 54% from 2019 (169 per 1,000) to 2021 (260 per 1,000).
  • The proportion of eating disorder-related hospitalizations was roughly 2.5 times higher in 2021 (50.3 per 1,000) compared with 2019 (19.7 per 1,000). This condition disproportionately affected females; in 2021, approximately 78 in every 1,000 hospitalizations among teen females presented with a diagnosis for an eating disorder, compared with nine in every 1,000 males.