JMIR Public Health Surveill. 2022 Dec 16. doi: 10.2196/43049. Online ahead of print.
ABSTRACT
BACKGROUND: The impact of the COVID-19 pandemic on mental health in general practice remains uncertain. Several studies showed an increase in terms of mental health problems during the pandemic. In Belgium, especially during the first waves of the pandemic, access to general practice was limited. Specifically, it is unclear how this impacted not only the registration of mental health problems itself, but also the care for patients with an existing mental health problem.
OBJECTIVE: To know the impact of the COVID-19 pandemic on 1) the incidence of newly registered mental health problems and 2) the provision of care for patients with mental health problems in general practice, both using a pre-COVID baseline.
METHODS: Pre-pandemic volume of provided care (care provision) for patients with mental health problems was compared to that in 2020 and 2021 by using INTEGO, a Belgian general practice morbidity registry. Care provision was defined as the total number of new registrations in a patient’s electronic medical record. Regression models evaluated the association of demographic factors and care provision in patients with mental health problems, both before and during the pandemic.
RESULTS: During the COVID-19 pandemic as compared to pre-COVID, the incidence of registered mental health problems showed a fluctuating course, with a sharp drop in registrations during the first wave. Registrations for depression and anxiety increased, whereas the incidence of registered eating disorders, substance abuse and personality problems decreased. During the five COVID-19 waves, the overall incidence of registered mental health problems dropped during the wave and rose again when measures were relaxed. A relative rise of 8.7% and 40% in volume of provided care, specifically for patients with mental health problems, was seen during the first and second year of the COVID-19 pandemic. Care provision for patients with mental health problems was higher: in older patients, males, patients living in center cities (centrumsteden), patients with lower socioeconomic status (SES), native Belgians and patients with acute rather than mental health problems. Compared to pre-pandemic care provision, a reduction of 10% was observed in people with a low SES.
CONCLUSIONS: This study showed 1) a relative overall increase in the registrations of mental health problems in general practice and 2) an increase in care provision for patients with mental health problems in the first two years of the COVID-19 pandemic. Low SES remained a determining factor for more care provision, but care provision dropped significantly in people with mental health problems with a low SES. Our findings suggest that the pandemic in Belgium was also largely a ‘syndemic’, affecting different layers of the population disproportionately.
PMID:36599160 | DOI:10.2196/43049
