Mental health-related healthcare service utilisation and psychotropic drug dispensation trends in British Columbia during COVID-19 pandemic: a population-based study

Abstract

BackgroundThe impact of the COVID-19 pandemic on the population’s mental health is vital for informing public health policy and decision-making. However, information on mental health-related healthcare service utilisation trends beyond the first year of the pandemic is limited.AimsWe examined mental health-related healthcare service utilisation patterns and psychotropic drug dispensations in British Columbia, Canada, during the COVID-19 pandemic compared with the prepandemic period.MethodsWe conducted a retrospective population-based secondary analysis using administrative health data to capture outpatient physician visits, emergency department visits, hospital admissions and psychotropic drug dispensations. We examined time trends of mental health-related healthcare service utilisation and psychotropic drug dispensations between January to December 2019 (prepandemic period) and January 2020 to December 2021 (pandemic period). In addition, we calculated age-standardised rates and rate ratios to compare mental health-related healthcare service utilisation before and during the first two years of the COVID-19 pandemic, stratified by year, sex, age and condition.ResultsBy late 2020, except for emergency department visits, utilisation of healthcare services recovered to prepandemic levels. Between 2019 and 2021, the monthly average rate for overall mental health-related outpatient physician visits, emergency department visits and psychotropic drug dispensations increased significantly by 24%, 5% and 8%, respectively. Notable and statistically significant increases were observed among 10–14 year-olds (44% in outpatient physician visits, 30% in emergency department visits, 55% in hospital admissions and 35% in psychotropic drug dispensations) and 15–19 year-olds (45% in outpatient physician visits, 14% in emergency department visits, 18% in hospital admissions and 34% in psychotropic drug dispensations). Additionally, these increases were more prominent among females than males, with some variation for specific mental health-related conditions.ConclusionsThe increase in mental health-related healthcare service utilisation and psychotropic drug dispensations during the pandemic likely reflects significant societal consequences of both the pandemic and pandemic management measures. Recovery efforts in British Columbia should consider these findings, especially among the most affected subpopulations, such as adolescents.

Psychotropic Medication Prescribing for Children and Adolescents After the Onset of the COVID-19 Pandemic

“… 22 , 23 Numerous studies worldwide have reported increases mainly in the prevalence of anxiety and depressive symptoms in young people 24 , 25 and in the number of hospitalizations and emergency department visits for severe mood disorders and suicidality in the year following the pandemic onset. 10 , 26 , 27 , 28 , 29 Consequent increments in psychotropic medication prescribing have been observed, often after a transient decrease during strict lockdowns, 11 , 12 , 13 , 30 , 31 but few studies have data to report on persisting effects associated with the pandemic. A Danish study 32 reported increases in the incident use of psychotropic medications (18%), mainly hypnotics, antidepressants, and psychostimulants, among children and adolescents up to mid-2022.…”

“…Population-based studies have reported increases in the uptake of antidepressants and hypnotics among youths (<18 or 19 years) in the months following the pandemic onset . Increases in overall psychotropic medication consumption, more important in the youngest age groups, were estimated at 35% among children 10 to 14 years of age and 15 to 19 years . However, data on psychotropic medication use in children and adolescents long after the pandemic onset are currently lacking.…”

“… 8 , 9 , 10 Increases in overall psychotropic medication consumption, more important in the youngest age groups, were estimated at 35% among children 10 to 14 years of age and 15 to 19 years. 11 , 12 , 13 However, data on psychotropic medication use in children and adolescents long after the pandemic onset are currently lacking. The purpose of the present study was to assess the rates and trends of psychotropic medication prescribing for children and adolescents before and in the 2 years after the onset of the COVID-19 pandemic in France.…”

Changes in real-world dispensing of ADHD stimulants in youth from 2019 to 2021 in California

“…An earlier behavioral questionnaire analysis revealed that the mental wellbeing of girls during the COVID-19 pandemic declined more than that of boys ( 23 ). In addition, studies have shown increases in mental health-related outpatient physician visits, emergency department visits and psychotropic drug prescriptions dispensed during the pandemic, with significant increases shown in the 10–19-year-old and female populations ( 24 ). In 2020 and 2021, 43.4 and 48.8% of new patients starting stimulant therapy were female, respectively, which were higher than the percentages of total female patients ≤26 years (37.4 and 41.1%).…”

Cohort profile: the British Columbia COVID-19 Cohort (BCC19C)—a dynamic, linked population-based cohort

“…These include negative impacts that go beyond the direct effect of viral infection on individual health. In an analysis exploring the impact on mental health, we found that trends in outpatient medical visits, emergency department visits and psychotropic drug dispensations increased following pandemic onset, particularly among adolescents (10–19 year olds) and females ( 19 ). Another study found the volume of ED visits reduce by 13% during the first 16-months of pandemic, with the biggest decrease among respiratory-related visits in the pediatric population ( 20 ).…”