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Physician visits for mental health concerns among children and youth in Ontario increased during the pandemic’s first year and rapidly shifted to virtual care


A study published today in JAMA Pediatrics found that overall in the first 12 months of the COVID-19 pandemic, the use of physician-based mental health-care services among Ontario children and youth was 10 to 15 percent higher than pre-pandemic levels.

The study, led by researchers at ICES and The Hospital for Sick Children (SickKids), looked at rates of in-person and virtual mental health-related visits to community pediatricians, family physicians and psychiatrists in Ontario. Their research examined trends among nearly 2.5 million Ontario residents aged three to 17 years in the three years before the onset of the COVID-19 pandemic (January 2017 to February 2020) and the year after (March 2020 to February 2021).

Following an initial decline in mental health visits, below expected levels, in the first four months of the pandemic, visit rates increased to above-expected levels by July 2020. In addition, mental health visits remained 10 to 15 percent higher than expected through February 2021.

Virtual care visits (conducted by telephone or video calls) accounted for 0.1 percent of physician visits in the pre-pandemic period. They peaked at 90 percent in April 2020 before levelling off to 70 percent by February 2021. Overall, while visits in outpatient settings increased during the pandemic’s first year, visits to acute care settings, such as emergency departments, and hospitalizations remained below or near expected levels.

Female individuals aged 13 to 17 experienced a disproportionate increase in mental health-care services, with physician visit rates ranging from 17 to 31 percent above the expected level from July 2020 onwards. Conversely, their male counterparts had visit rates similar to expected levels.

The authors indicate that system-level planning to monitor quality and ensure capacity for this modest but important rise in mental health-care needs is warranted.

“As seen in our findings, the COVID-19 pandemic had a significant impact on the mental health and well-being of children and youth, prompting many of them to seek care for these concerns,” says Dr. Natasha Saunders, lead author and staff physician, Division of Paediatric Medicine at SickKids. Dr. Alene Toulany, principal investigator and staff physician, Division of Adolescent Medicine at SickKids, adds, “ongoing surveillance is warranted to determine the longer-term patterns and impact as the pandemic evolves.” 

“Utilization of physician-based mental healthcare services among children and adolescents before and during the COVID-19 pandemic in Ontario, Canada: a population-based study” by Natasha R. Saunders, Paul Kurdyak, Therese A. Stukel, Rachel Strauss, Longdi Fu, Jun Guan, Lisa Fiksenbaum, Eyal Cohen, Astrid Guttmann, Simone Vigod, Maria Chiu, Charlotte Moore Hepburn, Kimberly Moran, William Gardner, Mario Cappelli, Purnima Sundar and Alene Toulany. JAMA Pediatrics, February 7, 2022.

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 healthcare 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

About SickKids
The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally. Its mission is to provide the best in complex and specialized family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system. SickKids is a founding member of Kids Health Alliance, a network of partners working to create a high quality, consistent and coordinated approach to pediatric healthcare that is centred around children, youth and their families. SickKids is proud of its vision for Healthier Children. A Better World. For more information, visit www.sickkids.ca. Follow us on Twitter (@SickKidsNews) and Instagram (@SickKidsToronto).

For further information, contact:

Niveen Saleh
Director of Communications, ICES
[email protected]

Jessamine Luck
Senior Communications Advisor
[email protected]

Read the Journal Article