Friday, January 21, 2022

Pandemic Sparks Increase in Mental Health, Substance Use Outpatient Visits Among Physicians

The number of outpatient visits for mental health and substance use by physicians jumped 27% in the first year of the COVID-19 pandemic, a study published today in JAMA Network Open has found.

“We observed increases in mental health and substance use visits during the COVID-19 pandemic that, consistent with surveys finding high levels of self-reported anxiety, depression, and stress in physicians during the pandemic, may indicate worsening physician mental health,” wrote Daniel T. Myran, M.D., M.P.H., of the Ottawa Hospital Research Institute in Canada and colleagues.

The researchers analyzed data from the records of 34,055 practicing physicians in the Ontario Health Insurance Plan from March 1, 2017, to March 10, 2021, to determine the participants’ rates of in-person or virtual outpatient visits to a psychiatrist or family medicine and general practice clinicians related to mental health and substance use. They compared the physicians’ visits during the first year of the pandemic in Ontario (March 11, 2020, to March 10, 2021) with those recorded before the pandemic.

The annual crude number of visits per 1,000 physicians rose from 816.8 before the pandemic to 1,375.5 during the pandemic. After adjusting for demographic and physician characteristics and a history of health care use related to mental health, visits increased by an average of 13% per physician. The largest relative increases in the rate of visits occurred among physicians who did not have a history of mental health problems or substance use.

“[T]hese findings suggest that generally, physicians have displayed resiliency during the pandemic, but a small group of physicians may have developed very high new mental health care needs during the pandemic, which are possibly related to pandemic-specific stressors,” Myran and colleagues wrote.

The proportion of physicians with one or more mental health and substance use visits within a year increased from 12.3% before the pandemic to 13.4% during the pandemic. Psychiatrists had the highest rate of visits (3,441.5 visits per 1,000 physicians) and surgeons had the lowest rates of visits (370.9 visits per 1,000 physicians). Overall, visits related to anxiety and adjustment reactions had the largest increases during the pandemic.

The researchers noted that the increase in visits may be explained by reduced barriers to health and mental health care, including an expansion in virtual care options in Ontario.

“It is possible that physicians with both physical and mental health concerns that predated the pandemic increased their health services use owing to this change (e.g., appointments are easier to schedule and less visible and thus less stigmatized),” they wrote.

For related information, see the Psychiatric News article “Physician Mental Health During COVID-19: A Call to Action.”

(Image: iStock/FG Trade)

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