Early phase of COVID-19 pandemic led to ‘dramatic changes’ in psychiatric care
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The early portion of the COVID-19 pandemic led to ‘dramatic changes’ in psychiatric care, which were primarily linked to the rapid transition to telehealth care, according to study results published in Journal of Clinical Psychiatry.
“We hoped to understand how large scale societal and personal disruptions associated with the COVID-19 pandemic may impact patient mental health needs,” study author Kathryn K. Ridout, MD, PhD, a clinician at Kaiser Permanente in Northern California, told Healio Psychiatry.
In the current retrospective observational study, Ridout and colleagues analyzed electronic health records data included in a large, community-based health care system between March 9 to May 31 in 2019 (n = 94,720) and for the same timeframe in 2020. They used percent change analysis to compare variables standardized to the average patient population for each time period.
Results showed a significant increase (P < .0001) in psychiatric visits for 2020 compared with 2019. Telephone/video-based visits accounted for the majority of the increase, with this form of visit increasing 264%. The researchers noted a 7% overall increase in psychiatric care volume, with a 42% increase in addiction, a 17% increase in behavioral health in primary care and a 5% increase in adult psychiatry clinics. Although the researchers noted general stability in the rate for patients seeking care with preexisting psychiatric diagnoses, new patients declined 42%. Further, they observed increases in visits of 15% for adjustment, 12% for anxiety, 9% for bipolar and 6% for psychotic disorder diagnoses, with visits for patients aged 18 to 25 years and patients aged 26 to 39 both increasing 4%. They noted a 22.7% decrease in child/adolescent visits and a 5.5% decrease in older adult visits, as well as a 3.8% decrease in patients who identified as white, a 5% decrease in those who identified as male, a 3% decrease in those with depression and a 2% decrease in those with disorders of childhood.
“These results can help providers understand the mental health needs of their patients during the pandemic, and how large changes in how individuals cope with social changes may impact their mental health,” Ridout said. “The changes we found in how patients used mental health services, and which patients accessed them, could reflect their relative comfort with telehealth technology or navigating the psychiatric care system. These data can inform health system resource management and guide future work examining how care delivery changes impact psychiatric care quality and access.”