Background Mental health conditions are common and often affect people’s social and work lives. The arrival of COVID-19 in 2020, and the lockdowns following this, increased the risk of mental health conditions as indicated by many qualitative and quantitative studies. We aimed to determine the incidence of ambulance calls for mental health presentations and to investigate the main predictors of these presentations in the East Midlands Region, before and during the COVID-19 pandemic.

Methods We used a cross-sectional design to determine incidence rates and predictors of mental health presentations to East Midlands Ambulance Service NHS Trust (EMAS), UK. Descriptive statistics were used to summarise the dataset from EMAS, and multiple logistic regression models were used to ascertain the main predictors of mental health presentations.

Results The incidence of mental health presentations to ambulance services significantly increased from 7.6% before COVID-19 to 8.6% during COVID-19 (p<0.001). The most significant differences were recorded for acute behavioural disturbance, with an increase from 3.2% to 6.6% (p<0.001), anxiety, with an increase from 37.4% to 39.3% (p<0.001), and intentional drug overdose, with a decrease from 20.0% to 17.2% (p<0.001). The main predictors of mental health presentations stayed the same before and during COVID-19 and these were people aged 20 to 30 years (compared with older age groups), females (compared with males), of White (compared with minority) ethnicity, from highly deprived (compared with affluent) areas, and from urban (compared with rural) areas.

Conclusions COVID-19 affected the frequency and profile of ambulance attendances for mental health presentations. Given the higher incidence of mental health presentations following COVID-19, additional support needs to be considered during pandemics including increased access to primary and community mental health services. Further research should be conducted in other regions of the UK, to observe if the findings are similar.