IJPDS International Journal of Population Data Science IJPDS 2399-4908 Swansea University 10.23889/ijpds.v9i5.2622 9:5:138 Utilization of Outpatient Mental Health Services During and After The COVID-19 Pandemic Hayek Michelle 1 Park Sulki 2 Lawley Mark 1 3 Michelle Bovin 3 Kum Hye-Chung 1 Texas A&M University The University of Texas Health Science Center at Houston VA Boston Healthcare System Boston University Chobanian & Avedisian School of Medicine 18 09 2024 2024 9 5 2622 This work is licenced under a Creative Commons Attribution 4.0 International License. This article is available from the IJPDS website at: https://ijpds.org/article/view/2622 Objective and Approach

This study examines the impact of COVID-19 on outpatient mental health (OP-MH) service use and assesses the role of telehealth on OP-MH service patterns. Using the 5% national sample of Medicare beneficiaries, the intervention group was defined as those newly diagnosed with a MH condition in 2019 (no MH diagnosis 2 years prior) with a 2-year study period of 2020-2021. The comparison group included non-overlapping individuals newly diagnosed in 2017 with a study period of 2018-2019. The OP utilization patterns were examined over the 2 years post-diagnosis and compared across MH diagnostic categories, including schizophrenia, bipolar, depression, anxiety, trauma-related, and substance-use disorders.

Results

The intervention group observed a significant reduction in MH utilization in March-April 2020 compared to the matched sample. While patients with schizophrenia and bipolar disorders saw a return to normal patterns by May 2020, those with depression, anxiety, trauma-related, and substance-use disorders continued to exhibit significant reductions in MH utilization post-COVID-19. The intervention group demonstrated a significant increase in telehealth usage, transitioning from 1% pre-COVID-19 to a peak of ~60% during the pandemic. This trend gradually decreased, reaching an average of 30% by the end of 2021 across all conditions.

 Conclusions and Implications

The intervention group observed a significant reduction in MH utilization in March-April 2020 compared to the matched sample. While patients with schizophrenia and bipolar disorders saw a return to normal patterns by May 2020, those with depression, anxiety, trauma-related, and substance-use disorders continued to exhibit significant reductions in MH utilization post-COVID-19. The intervention group demonstrated a significant increase in telehealth usage, transitioning from 1% pre-COVID-19 to a peak of ~60% during the pandemic. This trend gradually decreased, reaching an average of 30% by the end of 2021 across all conditions.