HOSPITALIZATIONS FOR MENTAL DISORDERS AMONG ADOLESCENTS IN BRAZIL (2019-2024): A TEMPORAL AND REGIONAL ANALYSIS IN THE CONTEXT OF THE COVID-19 PANDEMIC

Resumo

INTRODUCTION: Adolescent mental health has emerged as one of the leading public health concerns over the past decade, a scenario further impacted by the COVID-19 pandemic. In Brazil, structural weaknesses within the child and adolescent psychosocial care network were strained by social isolation and the reorganization of healthcare delivery, thereby exacerbating gaps in continuous care. Within this context, psychiatric hospitalizations among adolescents constitute a sensitive marker of mental illness severi ty, reflecting cases in which outpatient support was insufficient or absent. OBJECTIVE: To analyze temporal trends and regional variations in hospital admissions due to mental and behavioral disorders among adolescents in Brazil and across its macro-regions during the pre -, intra -, and post - pandemic periods. MATERIALS AND METHODS: A descriptive epidemiological study was conducted using secondary data extracted from the Brazilian Unified Health System Hospital Information System (SIH/SUS), made available via DATASUS. Hospitalizations recorded between 2019 and 2024 were included, considering individuals aged 10 to 19 years (adolescents according to the World Health Organization) and a primary diagnosis classified under Chapter V of the ICD -10 (F00-F99). Data were organized by year of care and Brazilian macro -region. The analysis was descriptive, with percentage variation calculated between the first and last years of the study period, considering 2019 as pre -pandemic, 2020-2021 as the pandemic period, and 2022-2024 as the post-pandemic period. RESULTS AND DISCUSSION: During the analyzed period, 118,488 psychiatric hospitalizations among adolescents were recorded in Brazil. In 2019, there were 21,097 admissions, which decreased to 16,067 in 2020 (-23.9%), coinciding with the period of greatest healthcare restrictions imposed by the COVID-19 pandemic. From 2021 onward, a progressive recovery was observed, with 17,478 admissions that year, reaching a peak of 22,123 in 2023 -exceeding pre-pandemic levels. In 2024, 21,164 admissions were recorded, maintaining this elevated level. Regionally, the South and Southeast accounted for the highest absolute numbers of hospitalizations, with 43,408 and 41,873, respectively. Despite this, the South experienced a reduction of 18. 1%, whereas the Southeast showed an increase of 13.9%. The Central-West also registered a decline of 20.4%. In contrast, the North and Northeast regions showed increases of approximately 24.7% and 24.6%, respectively, suggesting a rising demand in historic ally more vulnerable regions. The data reveal a biphasic pattern in psychiatric hospitalizations among Brazilian adolescents: a sharp decline in 2020, coinciding with pandemic -related healthcare restrictions, followed by a recovery that surpasses pre-pandemic levels. The disproportionate growth observed in the North and Northeast contrasts with the reductions seen in the South and Central -West-even in the post -pandemic period-which may be related to differences in outpatient and psychosocial care capacity, potentially containing cases before progression to hospitalization. The increase in the Southeast, in turn, should be interpreted in light of the region’s higher population density. CONCLUSION: These findings underscore the need for territorially sensitive public policies, with strengthening of the psychosocial care network in regions of greater socioeconomic vulnerability. As a limitation, the use of secondary data is highlighted, given its susceptibility to underreporting and the absence of population-adjusted analyses.