EClinicalMedicine (Apr 2024)
Effect of the COVID-19 pandemic on mental health visits in primary care: an interrupted time series analysis from nine INTRePID countriesResearch in context
- Javier Silva-Valencia,
- Carla Lapadula,
- John M. Westfall,
- Gabriela Gaona,
- Simon de Lusignan,
- Robert Sarkadi Kristiansson,
- Zheng Jye Ling,
- Lay Hoon Goh,
- Percy Soto-Becerra,
- Maria Sofia Cuba-Fuentes,
- Knut-Arne Wensaas,
- Signe Flottorp,
- Valborg Baste,
- William Chi-Wai Wong,
- Amy Pui Pui Ng,
- Angela Ortigoza,
- Jo-Anne Manski-Nankervis,
- Christine Mary Hallinan,
- Paula Zingoni,
- Luciano Scattini,
- Adrian Heald,
- Karen Tu,
- Karen Tu,
- Angela Ortigoza,
- Carla Lapadula,
- Paula Zingoni,
- Luciano Scattini,
- Jo-Anne Manski-Nankervis,
- Christine Mary Hallinan,
- Adrian Laughlin,
- William Chi-Wai Wong,
- Amy Pui Pui Ng,
- Zhou Li,
- Knut-Arne Wensaas,
- Signe Agnes Flottorp,
- Valborg Baste,
- Maria Sofia Cuba-Fuentes,
- Javier Silva-Valencia,
- Percy Soto-Becerra,
- Zheng Jye Ling,
- Lay Hoon Goh,
- Robert Kristiansson,
- Mats Martinell,
- Simon de Lusignan,
- Uy Hoang,
- Adrian Heald,
- Wilson Pace,
- John M. Westfall,
- Gabriela Gaona,
- Michael Kidd
Affiliations
- Javier Silva-Valencia
- Center for Research in Primary Health Care (CINAPS), Universidad Peruana Cayetano Heredia, Peru
- Carla Lapadula
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- John M. Westfall
- DARTNet Institute, Aurora, CO, USA
- Gabriela Gaona
- DARTNet Institute, Aurora, CO, USA
- Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Robert Sarkadi Kristiansson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Zheng Jye Ling
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Lay Hoon Goh
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Percy Soto-Becerra
- School of Medicine, Universidad Continental, Huancayo, Peru
- Maria Sofia Cuba-Fuentes
- Center for Research in Primary Health Care (CINAPS), Universidad Peruana Cayetano Heredia, Peru
- Knut-Arne Wensaas
- Research Unit for General Practice, NORCE Norwegian Research Centre AS, Bergen, Norway
- Signe Flottorp
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway; Department of General Practice, University of Oslo, Oslo, Norway
- Valborg Baste
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
- William Chi-Wai Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China; Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Amy Pui Pui Ng
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China; Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Angela Ortigoza
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Jo-Anne Manski-Nankervis
- Department of General Practice and Primary Care, The University of Melbourne, Melbourne, Victoria, Australia
- Christine Mary Hallinan
- Department of General Practice and Primary Care, The University of Melbourne, Melbourne, Victoria, Australia
- Paula Zingoni
- Ministry of Health of the Autonomous City of Buenos Aires, Buenos Aires, Argentina
- Luciano Scattini
- Ministry of Health of the Autonomous City of Buenos Aires, Buenos Aires, Argentina
- Adrian Heald
- School of Medical Sciences, Division of Diabetes, Endocrinology and Gastroenterology, University of Manchester, UK
- Karen Tu
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; Departments of Research and Innovation and Family Medicine-North York General Hospital, Toronto Western Family Health Team-University Health Network, Toronto, Ontario, Canada; Corresponding author. 500 University Avenue, 3rd floor, Toronto, Ontario, M5G 1V7, Canada.
- Karen Tu
- Angela Ortigoza
- Carla Lapadula
- Paula Zingoni
- Luciano Scattini
- Jo-Anne Manski-Nankervis
- Christine Mary Hallinan
- Adrian Laughlin
- William Chi-Wai Wong
- Amy Pui Pui Ng
- Zhou Li
- Knut-Arne Wensaas
- Signe Agnes Flottorp
- Valborg Baste
- Maria Sofia Cuba-Fuentes
- Javier Silva-Valencia
- Percy Soto-Becerra
- Zheng Jye Ling
- Lay Hoon Goh
- Robert Kristiansson
- Mats Martinell
- Simon de Lusignan
- Uy Hoang
- Adrian Heald
- Wilson Pace
- John M. Westfall
- Gabriela Gaona
- Michael Kidd
- Journal volume & issue
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Vol. 70
p. 102533
Abstract
Summary: Background: The COVID-19 pandemic impacted mental health disorders, affecting both individuals with pre-existing conditions and those with no prior history. However, there is limited evidence regarding the pandemic's impact on mental health visits to primary care physicians. The International Consortium of Primary Care Big Data Researchers (INTRePID) explored primary care visit trends related to mental health conditions in Argentina, Australia, Canada, China, Norway, Peru, Singapore, Sweden, and the USA. Methods: We conducted an interrupted time series analysis in nine countries to examine changes in rates of monthly mental health visits to primary care settings from January 1st, 2018, to December 31st, 2021. Sub-group analysis considered service type (in-person/virtual) and six categories of mental health conditions (anxiety/depression, bipolar/schizophrenia/other psychotic disorders, sleep disorders, dementia, ADHD/eating disorders, and substance use disorder). Findings: Mental health visit rates increased after the onset of the pandemic in most countries. In Argentina, Canada, China, Norway, Peru, and Singapore, this increase was immediate ranged from an incidence rate ratio of 1·118 [95% CI 1.053–1.187] to 2.240 [95% CI 2.057–2.439] when comparing the first month of pandemic with the pre-pandemic trend. Increases in the following months varied across countries. Anxiety/depression was the leading reason for mental health visits in most countries. Virtual visits were reported in Australia, Canada, Norway, Peru, Sweden, and the USA, accounting for up to 40% of the total mental health visits. Interpretation: Findings suggest an overall increase in mental health visits, driven largely by anxiety/depression. During the COVID-19 pandemic, many of the studied countries adopted virtual care in particular for mental health visits. Primary care plays a crucial role in addressing mental ill-health in times of crisis. Funding: Canadian Institutes of Health Research grant #173094 and the Rathlyn Foundation Primary Care EMR Research and Discovery Fund.
