Emergency presentations following youth suicide attempts during the COVID-19 pandemic: temporal trends and associations with containment measures.

The COVID-19 pandemic has raised concerns about adverse effects on youth mental health, including suicidal behavior. While suicide mortality remained stable in many countries, less is known about temporal changes in suicide attempts presenting to clinical services. This study examined trends in psychiatric emergency presentations following suicide attempts among children and adolescents across COVID-19 pandemic phases and their association with the intensity of governmental containment measures. A retrospective analysis was conducted at a tertiary care center in Vienna, Austria, between January 2019 and December 2023, distinguishing pre-pandemic, pandemic, and post-pandemic periods. COVID-19 containment stringency was quantified using the Oxford COVID-19 Government Response Tracker Stringency Index. Temporal changes in monthly suicide attempt presentations were analyzed using Poisson regression models, adjusting for linear time trends. A total of 6,319 psychiatric emergency presentations were recorded, including 722 presentations following suicide attempts (11.4%). Compared with the pre-pandemic period, suicide attempt-related presentations increased significantly during the pandemic (RR = 1.80, p < .001), while the post-pandemic period did not differ significantly from pre-pandemic levels. Higher monthly suicide attempt presentation rates were associated with greater containment stringency (RR per point = 1.007, p < .001). An independent upward temporal trend in suicide attempt presentations was observed across the study period. Associations with policy stringency and persistent temporal trends suggest that suicide attempts may serve as an indicator of psychosocial burden not captured by mortality data alone. Continuous monitoring of emergency presentations and access to low-threshold mental health support are necessary beyond periods of acute crisis.