Physicians struggled more with mental health during the pandemic than the general population
Outpatient mental health and substance use visits in physicians increased by 23%, compared to only 10% for the general public in the first 18 months of the pandemic, according to a new study from ICES and The Ottawa Hospital.
This large study of over 12 million Ontarians, including over 40,000 physicians, is the first to compare the use of mental health services by physicians and the general public before and during the COVID-19 pandemic.
“Physicians worldwide have reported large increases in symptoms of depression, anxiety and burnout during the COVID-19 pandemic,” says lead author and ICES trainee Daniel Myran, who is also a family physician and Fellow at the Bruyère Research Institute and The Ottawa Hospital. “It was unclear if this was because of occupational stressors, general pandemic stressors, or both. Our findings raise concern that the mental health of physicians may have been much more negatively impacted during the pandemic than the general population.”
Published in PLOS Medicine, the researchers examined medical record data of outpatient and hospital mental health visits in Ontario, Canada. They compared changes in visits for physicians and the general population pre- and post-pandemic (March 2017 to August 2021).
The data showed that:
- Before the pandemic, physicians had comparable rates of outpatient mental health and addictions (MHA) visits as the general public, but physicians had higher rates of visits to psychiatrists and lower rates of visits to family doctors.
- During the first 18 months of the COVID-19 pandemic, the rate of outpatient MHA visits increased by 23.2% in physicians compared to 9.8% for the general public.
- After the pandemic started, physicians also had a 4 times greater increase in virtual care MHA visits than the general public (4612% versus 1054%).
“The upside of these findings is that we saw large numbers of physicians seeking care for their mental health,” says Dr. Myran. “Stigma towards physicians accessing mental health services has long been a problem in medicine, and I am hopeful that both increased awareness during COVID-19 and potentially improved access to virtual care have started to break down some of these barriers.”
One limitation of the study is that while physicians – given that they work within healthcare – likely had much greater increases in mental health visits than the general population, it’s difficult to tease apart whether this is a specific worsening of physician mental health, differences in changes in access, or both. For example, virtual care may have reduced barriers for physicians to seek care more so than for the general public. This may have also improved access for physicians with pre-pandemic mental health concerns.
Nevertheless, the researchers say that their findings shed light on mental health challenges that are unique to physicians’ experiences during the pandemic. Occupational stressors, such as increased workload, social isolation, rapidly changing policies, and a shortage of healthcare workers, may have influenced physician rates of mental health service use.
“These challenges will likely continue after the pandemic is over, given the residual strain on the healthcare system,” says Dr. Myran. “There is an urgent need to continue to increase interventions that reduce occupational stressors and improve workplace mental health for physicians.”
The study, “Outpatient mental health and addiction service use by physicians compared to non-physicians before and during the COVID-19 pandemic: a population-based cohort study” was published in PLOS Medicine.
Author block: Myran DT, Roberts R, McArthur E, Jeyakumar N, Hensel JM, Kendall C, Gerin-Lajoie C, McFadden T, Simon C, Garg AX, Sood MM, Tanuseputro P.
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