As Catawba County continues to move forward and cope with the unintended consequences of COVID-19, access to equitable and affordable primary care that incorporates behavioral is both an applicable and realistic need. In 2019, 15.5% of all emergency department visits were for anxiety, mood, and psychotic disorders. From January 1 to November 30, 2020, 15.8% of all emergency department visits have been for anxiety, mood, and psychotic disorders (The University of North Carolina at Chapel Hill, 2020).
Behavioral health conditions, such as anxiety, mood, and psychotic disorders, affect a person’s thinking, feeling, mood, or behavior in a way that influences their ability to relate to others and function each day. These conditions may be situational, short-term, or long-lasting, chronic (Centers for Disease Control and Prevention, 2020). Emergency department visits are categorized by ICD-10-CM codes and anxiety, mood, and psychotic disorders are defined as follows:
- Anxiety disorders are a category of behavioral health disorders characterized by feelings of anxiety and fear, where anxiety is a worry about future events and fear is a reaction to current events. These feelings may cause physical symptoms, such as a racing heart and shakiness. There are a number of anxiety disorders including generalized anxiety disorder, a specific phobia, social anxiety disorder, separation anxiety disorder, agoraphobia, and panic disorder among others. While each has its own characteristics and symptoms, they all include symptoms of anxiety (UNC, 2020).
- Mood Disorders include bipolar disorder, also known as bipolar affective disorder or manic depression, and major depressive disorder. Bipolar disorder is a mental disorder characterized by periods of elevated mood and periods of depression. The elevated mood is significant and is known as mania or hypomania depending on the severity or whether there is psychosis. During mania an individual feels or acts abnormally happy, energetic, or irritable. They often make poorly thought out decisions with little regard to the consequences. The need for sleep is usually reduced. Major depressive disorder, also known as clinical depression, major depression, unipolar depression, or unipolar disorder; or as recurrent depression in the case of repeated episodes, is a mental disorder characterized by a pervasive and persistent low mood that is accompanied by low self-esteem and by a loss of interest or pleasure in normally enjoyable activities. The term "depression" is used in a number of different ways. It is often used to mean this syndrome but may refer to other mood disorders or simply to a low mood (UNC, 2020).
- For psychotic disorders, psychosis refers to an abnormal condition of the mind described as involving a "loss of contact with reality". People with psychosis are described as psychotic. People experiencing psychosis may exhibit some personality changes and thought disorder. Depending on its severity, this may be accompanied by unusual or bizarre behavior, as well as difficulty with social interaction and impairment in carrying out daily life activities (UNC, 2020).
The Behavioral Health Work Group continues to consider if they have a full understanding of root causes and continue to discuss equity, stigma, non-medical drivers/ social determinants of health, case management and lack of wrap around services.
Centers for Disease Control and Prevention. (2020). Coronavirus Disease 2019: Coping with Stress. Retrieved on December 3, 2020 from https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html.
The University of North Carolina at Chapel Hill. (2020). NCDETECT- Emergency Department Data for Catawba County for Anxiety, Mood, and Psychotic Disorders from 1/1/2019 to 11/30/2020. Retrieved on December 1, 2020 from https://ncdetect.org/.