Using Machine Learning to Mine Mental Health Diagnostic Groups from Emergency Department Presentations Before and During the COVID-19 Pandemic

Abstract:
Purpose The COVID-19 pandemic had a profound negative efect on mental health worldwide. The hospital emergency department plays a pivotal role in responding to mental health crises. Understanding data trends relating to hospital emergency department usage is benefcial for service planning, particularly around preparing for future pandemics.
Machine learning has been used to mine large volumes of unstructured data to extract meaningful data in relation to
mental health presentations. This study aims to analyse trends in fve mental health-related presentations to an emergency department before and during, the COVID-19 pandemic.

Methods:
Data from 690,514 presentations to two Australian, public hospital emergency departments between April
2019 to February 2022 were assessed. A machine learning-based framework, Mining Emergency Department Records, Evolutionary Algorithm Data Search (MEDREADS), was used to identify suicidality, psychosis, mania, eating disorder, and substance use.

Results:
While the mental health-related presentations to the emergency department increased during the COVID-19 pandemic compared to pre-pandemic levels, the proportion of mental health presentations relative to the total emergency
department presentations decreased. Several troughs in presentation frequency were identifed across the pandemic period, which occurred consistently during the public health lockdown and restriction periods.

Conclusion:
This study implemented novel machine learning techniques to analyse mental health presentations to an emergency department during the COVID-19 pandemic. Results inform understanding of the use of emergency mental
health services during the pandemic, and highlight opportunities to further investigate patterns in presentation.