Doctors using more mental health services during pandemic: study

Doctors, like nearly everyone else, have experienced strains on their mental health during the COVID-19 pandemic. But the effects have been particularly acute among doctors without prior histories of mental health or substance use problems, a new study finds.

The study compares the rate of outpatient visits for mental health and substance abuse for the 12 months following and preceding the start of the pandemic among 34,000 physicians, residents and fellows in Ontario, Canada.

It found that the proportion of respondents making first-time mental health/substance abuse visits during the pandemic grew by 40.6%, compared with a 19.3% increase among those who had made such visits before the start of the pandemic. Overall, the annual number of visits was up by 27%, from 816.8 to 1,037.6 per thousand physicians.

The findings suggest, according to the researchers, that the increases in visits result from both an increase in the number of doctors accessing mental health services and in the number of those with multiple mental health visits.

“Together, these findings suggest that generally, physicians have displayed resiliency during the pandemic, but a small group may have developed very high new mental health care needs…which are possibly related to pandemic-specific stressors.”

Among practicing specialists, surgeons and anesthesiologists were the least likely to seek mental health/substance abuse help, with 460.6 and 740.3 visits per thousand physicians, respectively. On the other hand, visits among anesthesiologists grew by 74% after the start of the pandemic, the largest among any of the specialties in the study. Specialties with the greatest number of visits were psychiatrists (4,252 per thousand) and family physicians (890.3 per thousand.)

The authors note that while earlier studies have shown prolonged contact with COVID-infected patients to be a risk factor for negative psychological outcomes, their results found little difference between respondents who did or did not provide acute care for these patients. They speculate this may be because physicians providing acute care for COVID-19 patients had lower rates of mental health/substance abuse visits before the pandemic.

This result may, in turn, suggest that this group of doctors has greater resilience to mental health conditions, be more reluctant to seek mental health care, or a combination of the two that continued during the pandemic. Another possibility is that their increased workloads during the pandemic may not have allowed them time to seek mental health care.

The authors say that their findings of increases in mental health/substance abuse visits, when combined with surveys of doctors showing high levels of self-reported anxiety, depression and stress, may indicate worsening mental health among doctors generally.

The study, “Physician Health Care Visits for Mental Health and Substance Use During the COVID-19 Pandemic in Ontario, Canada” was published January 21 on JAMA Network Open.