Mental health-related healthcare utilization and psychotropic drug dispensation trends in British Columbia during the COVID-19 pandemic: Observational Study (Preprint)
Bibliographic record
Abstract
BACKGROUND The impact of the coronavirus disease (COVID-19) pandemic on mental health of the population is important for informing public health policy and decision-making. However, there is limited information on trends in mental health-related healthcare service utilization during the pandemic. OBJECTIVE This study aimed to describe patterns of mental health-related healthcare service utilisation and psychotropic drug dispensations in British Columbia, Canada, during the COVID-19 pandemic compared to a pre-pandemic period. We explored trajectories of use across multiple data sources to determine whether the patterns were similar or different in acute and outpatient settings, and how these patterns differed by age, sex and type of condition. METHODS We conducted a population-based study 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 utilisation and psychotropic drug dispensations between January 2019 and December 2021. We calculated age-standardised rates and rate ratios to compare healthcare service utilisation before and during the COVID-19 pandemic and stratified by year, sex, age and condition. RESULTS Results: In April 2020, compared to the same period in 2019, we observed a 26% and 16% decrease in acute care visits for mental health-related emergency department visits and hospital admissions, respectively. By late 2020, with the exception of emergency department visits, healthcare service utilisation recovered to pre-pandemic (2019) levels. In 2021, overall mental health-related healthcare service utilisation increased to above pre-pandemic levels, with an increase in the monthly average rate of 22% for outpatient physician visits only and not in other datasets. However, notable and statistically significant increases in healthcare utilisation were observed across all data sources among 10-14 year olds (45% in outpatient physician visits, 31% in emergency department visits, 55% in hospital admissions, and 36% in psychotropic drug dispensations), and 15-19 year olds (51% in outpatient physician visits, 19% in emergency department visits, 13% in hospital admissions, and 39% in psychotropic drug dispensations). Increases were more prominent among females than males, but there was some variation for specific mental health-related conditions. CONCLUSIONS The increase in mental health-related healthcare utilisation and psychotropic drug dispensations in 2020 and 2021 likely reflects important societal consequences of both the pandemic itself and the associated measures. Recovery efforts in British Columbia should take these findings into consideration, especially among most affected sub-populations, such as adolescents. CLINICALTRIAL Not applicable.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.008 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".