Frontiers in Psychiatry (Nov 2023)
New and continuing physician-based outpatient mental health care among children and adolescents during the COVID-19 pandemic in Ontario, Canada: a population-based study
- Alene Toulany,
- Alene Toulany,
- Alene Toulany,
- Alene Toulany,
- Alene Toulany,
- Alene Toulany,
- Simone Vigod,
- Simone Vigod,
- Simone Vigod,
- Simone Vigod,
- Paul Kurdyak,
- Paul Kurdyak,
- Paul Kurdyak,
- Paul Kurdyak,
- Therese A. Stukel,
- Therese A. Stukel,
- Rachel Strauss,
- Longdi Fu,
- Astrid Guttmann,
- Astrid Guttmann,
- Astrid Guttmann,
- Astrid Guttmann,
- Astrid Guttmann,
- Astrid Guttmann,
- Jun Guan,
- Eyal Cohen,
- Eyal Cohen,
- Eyal Cohen,
- Eyal Cohen,
- Eyal Cohen,
- Eyal Cohen,
- Maria Chiu,
- Maria Chiu,
- Charlotte Moore Hepburn,
- Charlotte Moore Hepburn,
- Charlotte Moore Hepburn,
- Kimberly Moran,
- William Gardner,
- William Gardner,
- Mario Cappelli,
- Purnima Sundar,
- Natasha Saunders,
- Natasha Saunders,
- Natasha Saunders,
- Natasha Saunders,
- Natasha Saunders,
- Natasha Saunders
Affiliations
- Alene Toulany
- The Hospital for Sick Children, Toronto, ON, Canada
- Alene Toulany
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Alene Toulany
- ICES, Toronto, ON, Canada
- Alene Toulany
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
- Alene Toulany
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Alene Toulany
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, ON, Canada
- Simone Vigod
- ICES, Toronto, ON, Canada
- Simone Vigod
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Simone Vigod
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Simone Vigod
- Women’s College Hospital, Women’s College Research Institute, Toronto, ON, Canada
- Paul Kurdyak
- ICES, Toronto, ON, Canada
- Paul Kurdyak
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Paul Kurdyak
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Paul Kurdyak
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Therese A. Stukel
- ICES, Toronto, ON, Canada
- Therese A. Stukel
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Rachel Strauss
- ICES, Toronto, ON, Canada
- Longdi Fu
- ICES, Toronto, ON, Canada
- Astrid Guttmann
- The Hospital for Sick Children, Toronto, ON, Canada
- Astrid Guttmann
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Astrid Guttmann
- ICES, Toronto, ON, Canada
- Astrid Guttmann
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
- Astrid Guttmann
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Astrid Guttmann
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, ON, Canada
- Jun Guan
- ICES, Toronto, ON, Canada
- Eyal Cohen
- The Hospital for Sick Children, Toronto, ON, Canada
- Eyal Cohen
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Eyal Cohen
- ICES, Toronto, ON, Canada
- Eyal Cohen
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
- Eyal Cohen
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Eyal Cohen
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, ON, Canada
- Maria Chiu
- ICES, Toronto, ON, Canada
- Maria Chiu
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Charlotte Moore Hepburn
- The Hospital for Sick Children, Toronto, ON, Canada
- Charlotte Moore Hepburn
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Charlotte Moore Hepburn
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, ON, Canada
- Kimberly Moran
- 0Children’s Mental Health Ontario, Toronto, ON, Canada
- William Gardner
- 1Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- William Gardner
- 2School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Mario Cappelli
- 3Knowledge Institute on Child and Youth Mental Health and Addictions, Ottawa, ON, Canada
- Purnima Sundar
- 3Knowledge Institute on Child and Youth Mental Health and Addictions, Ottawa, ON, Canada
- Natasha Saunders
- The Hospital for Sick Children, Toronto, ON, Canada
- Natasha Saunders
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Natasha Saunders
- ICES, Toronto, ON, Canada
- Natasha Saunders
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
- Natasha Saunders
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Natasha Saunders
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, ON, Canada
- DOI
- https://doi.org/10.3389/fpsyt.2023.1063203
- Journal volume & issue
-
Vol. 14
Abstract
ObjectiveTo assess physician-based mental health care utilization during the COVID-19 pandemic among children and adolescents new to care and those already engaged with mental health services, and to evaluate differences by sociodemographic factors.Study designWe performed a population-based repeated cross-sectional study using linked health and administrative databases in Ontario, Canada among all children and adolescents 3–17 years. We examined outpatient visit rates per 1,000 population for mental health concerns for those new to care (no physician-based mental healthcare for ≥1 year) and those with continuing care needs (any physician-based mental healthcare <1 year) following onset of the pandemic.ResultsAmong ~2.5 million children and adolescents (48.7% female, mean age 10.1 ± 4.3 years), expected monthly mental health outpatient visits were 1.5/1,000 for those new to mental health care and 5.4/1,000 for those already engaged in care. Following onset of the pandemic, visit rates for both groups were above expected [adjusted rate ratio (aRR) 1.22, 95% CI 1.17, 1.27; aRR 1.10, 95% CI 1.07, 1.12] for new and continuing care, respectively. The greatest increase above expected was among females (new: aRR 1.33, 95% CI 1.25, 1.42; continuing: aRR 1.22 95% CI 1.17, 1.26) and adolescents ages 13–17 years (new: aRR 1.31, 95% CI 1.27, 1.34; continuing: aRR 1.15 95% CI 1.13, 1.17). Mood and anxiety concerns were prominent among those new to care.ConclusionIn the 18 months following onset of the pandemic, outpatient mental health care utilization increased for those with new and continuing care needs, especially among females and adolescents.
Keywords
