Impact of the Coronavirus Disease 2019 Pandemic on Mental Health Visits in Pediatric Primary Care

Abstract

Objectives: Describe the impact of the coronavirus disease 2019 (COVID-19) pandemic on pediatric primary care visits for 7 mental health categories before and during the COVID-19 pandemic.

Methods: This interrupted time series analysis compared the rate of mental health visits to pediatric primary care providers in Massachusetts before and during the COVID-19 pandemic. Three time periods were defined: prepandemic period (January 2019-February 2020), emergency pandemic period (March 2020-May 2020), and pandemic period (June 2020-September 2021). The 7 mental health visit diagnoses included alcohol and substance use disorders, anxiety disorders, attention-deficit hyperactivity disorders, behavior disorders, eating disorders, mood disorders (depressive and bipolar), and stress or trauma disorders.

Results: Significant increases in slope (P < .001) were observed for eating disorder visits, with the annualized visit rate increasing from 9.3 visits per 1000 patients per year in the prepandemic period to 18.3 in the pandemic period. For mood disorder visits, the annualized visit rate increased from 65.3 in the prepandemic period to 94.0 in the pandemic period. Significant decreases in level and slope (both P < .001) were observed for alcohol and substance use disorder visits, with the annualized visit rate decreasing from 5.8 in the prepandemic period to 5.5 in the pandemic period.

Conclusions: Eating disorder visits and mood disorder visits significantly increased, whereas alcohol and substance use disorder visits significantly decreased during the pandemic period among pediatric patients, highlighting the need to identify and manage mental health conditions in the pediatric primary care setting.