Youth Mental Health-Related Emergency Department Visits After Hurricane Helene: A Difference-in-Differences Analysis.

IF 4.5

The Journal of adolescent health : official publication of the Society for Adolescent Medicine Pub Date : 2026-10-19 DOI:10.1016/j.jadohealth.2026.08.013

Kelsey Herbst, Maggie M Sugg, Jennifer D Runkle

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Abstract

Purpose: Extreme weather can disrupt social supports, schooling, and access to behavioral health services, potentially affecting youth mental health. This study examined changes in youth mental health-related emergency department (ED) visits following Hurricane Helene (2024).

Methods: ED surveillance data from North Carolina (2022-2024) were used to assess mental health-related visits among youth aged 5-26. A difference-in-difference (DID) design compared FEMA-designated disaster counties with nondeclared counties before and after the storm. Multilevel intersectional analyses evaluated risk by sex, race/ethnicity, age, and insurance.

Results: Anxiety-related ED visits increased in disaster-exposed counties post-Helene (DID_RR = 1.14, 95% confidence interval [CI]: 1.01-1.29), with larger increases among females than males (DID_RR = 1.18, 95% CI: 1.03-1.35). Depression also showed greater relative increases among females (difference-in-difference-in-differences_RR = 1.28, 95% CI: 1.09-1.51). Self-harm visits declined overall (DID_RR = 0.70, 95% CI: 0.52-0.94).

Discussion: Hurricane Helene was associated with shifts in youth mental health-related ED use, demonstrating the need to strengthen adolescent and young adult behavioral health services in disaster-prone rural communities.

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飓风“海伦”后青少年心理健康急诊就诊：差异中的差异分析

目的：极端天气会破坏社会支持、学校教育和获得行为健康服务的机会，潜在地影响青少年的心理健康。本研究调查了飓风“海伦”（2024）后青少年心理健康急诊就诊的变化。方法：使用北卡罗来纳州（2022-2024）的ED监测数据来评估5-26岁青少年的心理健康就诊情况。一项差中差（DID）设计将联邦应急管理局指定的受灾县与未宣布的县在风暴前后进行了比较。多水平交叉分析通过性别、种族/民族、年龄和保险来评估风险。结果：在受灾县，与焦虑相关的急诊就诊增加（DIDRR = 1.14, 95%可信区间[CI]: 1.01-1.29），女性的增加幅度大于男性（DIDRR = 1.18, 95% CI: 1.03-1.35）。抑郁症在女性中也显示出更大的相对增加（差异中差异中的差异rr = 1.28, 95% CI: 1.09-1.51）。自残率总体下降（DIDRR = 0.70, 95% CI: 0.52-0.94）。讨论：飓风“海伦”与青少年心理健康相关的ED使用变化有关，这表明有必要在易受灾害的农村社区加强青少年和年轻人的行为健康服务。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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The Journal of adolescent health : official publication of the Society for Adolescent Medicine

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