New research from Women’s College Hospital and ICES shows that postpartum mental health visits are up significantly during COVID-19
A new population-based study published today in CMAJ shows that during the first nine months of the COVID-19 pandemic postpartum mental health visits across Ontario were 30 per cent higher than expected by pre-pandemic rates. Anxiety, depression and alcohol and substance use disorders drove the elevated visit numbers, most notably for people who were in their first 90 days postpartum.
“While there has been and continues to be a lot of discussion in the media and elsewhere about the emotional and mental health impacts of COVID-19 on parents, particularly mothers, this is the first population-based study actually looking at the clinical burden of postpartum mental illness during the pandemic,” explained Dr. Simone Vigod, chief of psychiatry, senior scientist and interim vice president of academics at Women’s College Hospital (WCH), senior adjunct scientist at ICES and study lead.
“The postpartum period is often a physically and mentally taxing time for new parents. Compound this with the additional restrictions put in place during COVID-19, as well as the financial and social disruptions that it precipitated,” added Vigod. Newly delivered people, in their first 90 days postpartum, may be disproportionately impacted as they frequently rely on family, friends and other networks for support, which have been less accessible.
The study also found that those living in lower income areas had the smallest visit rate increase. This finding is particularly concerning as this segment of the population has been most heavily affected by the pandemic.
“Virtual care has increased substantially in the past year, and many family physician and psychiatrist visits have moved to telephone or video,” Vigod said. “Postpartum, those who are lower income may have difficulty affording the required technology for a virtual visit, they may not be able to find a private space for visits and they may be unable to attend “live” appointments if they are essential workers. And while physician visits are covered by OHIP, prescription medication and non-physician services, like psychotherapy services delivered in the community by non-physicians, are not.”
The study data also found that those with South Asian surnames experienced an elevation of postpartum mental health visits later in the pandemic in comparison to those from other socio-cultural groups. And that while Northern Ontario has fewer mental health resources available, rates were elevated above pre-pandemic levels until July. However, from August 2020 onwards postpartum mental health visit rates were much closer to the rates expected by pre-pandemic patterns, perhaps as a result of a lessening of restrictions after that time.
“As the pandemic progresses, health systems should focus on postpartum people from high-risk groups, monitor wait lists for care and explore creative solutions to expand system capacity, with a particular focus on enhancing equity and access”, stated Vigod.
“Postpartum mental illness during the COVID-19 pandemic: a population-based, repeated cross-sectional study”. Simone N. Vigod, Hilary K. Brown, Anjie Huang, Kinwah Fung, Lucy C. Barker, Neesha Hussain-Shamsy, Elisabeth Wright, Cindy-Lee Dennis, Sophie Grigoriadis, Peter Gozdyra, Daniel Corsi, Mark Walker, Rahim Moineddin. CMAJ. June 5, 2021.
About Women’s College Hospital
For more than 100 years Women’s College Hospital (WCH) has been developing revolutionary advances in healthcare. Today, WCH is a world leader in the health of women and Canada’s leading, academic ambulatory hospital. A champion of health equity, WCH advocates for the health of all women from diverse cultures and backgrounds and ensures their needs are reflected in the care they receive. It focuses on delivering innovative solutions that address Canada’s most pressing issues related to population health, patient experience and system costs. The WCH Institute for Health System Solutions and Virtual Care (WIHV) is developing new, scalable models of care that deliver improved outcomes for patients and sustainable solutions for the health system as a whole. www.womenscollegehospital.ca
ICES is an independent, non-profit research institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. In October 2018, the institute formerly known as the Institute for Clinical Evaluative Sciences formally adopted the initialism ICES as its official name. For the latest ICES news, follow us on Twitter: @ICESOntario
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