Mental health consequences of the COVID-19 pandemic: Results from a large-scale population-based study in Israel

https://doi.org/10.1016/j.comppsych.2023.152383Get rights and content
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Highlights

  • Use of mental health services reduced during the first year of COVID-19.

  • Younger patients demonstrated an increase in utilization of mental health services.

  • Older patients (age 55–80) showed a decrease in use of mental health services.

  • Utilization was affected by distress levels and reluctance to seek professional aid.

Abstract

Introduction

Contemporary evidence notes the COVID-19 pandemic greatly impacted the utilization of physical and mental health services worldwide. The present study was therefore designed to evaluate the changes in the utilization of mental health services during the first year of the COVID-19 pandemic compared to previous years as well as to estimate the moderating role age had on these changes.

Materials and methods

Psychiatric data was collected from n = 928,044 individuals living in Israel. Rates of receipt of psychiatric diagnoses and purchases of psychotropic medication were extracted for the first year of the COVID-19 pandemic and for two comparison years. The odds of receiving a diagnosis or of purchasing a psychotropic medication during the pandemic were compared to control years using uncontrolled logistic regression models and controlled and logistic regression that accounted for differences between ages.

Results

There was a general reduction of about 3–17% in the odds of receiving a psychiatric diagnosis or purchasing psychotropic medications during the pandemic year compared to control years. The bulk of tests conducted showed that reduction in the rates of receiving diagnoses and purchasing medications during the pandemic were evident or more profound in the older age groups. An analysis of a combined measure conclusive of all other measures revealed decreased rates of utilizing any service examined during 2020, with rates decreasing as age increases up to a decrease of 25% in the oldest age group (80–96).

Discussion and conclusion

Changes in utilization of mental health services reveal the interplay between psychological distress that has been documented to increase during the pandemic and people's reluctance to seek professional assistance. This appears to be especially prominent among the vulnerable elderly, who may have received even less professional help for their emerging distress. The results obtained in Israel are likely to be replicated in other countries as well, given the global impact of the pandemic on adults' mental health and individuals' readiness to utilize mental healthcare services. Future research on the long-term impact of the pandemic on utilization of mental healthcare services is warranted, with an emphasis on the response of different populations to emergency situations.

Keywords

COVID-19
MENTAL healthcare utilization
depression
Anxiety
Psychotropic medication

Data availability

Individual participant data will not be available due to the CHS's confidentiality restrictions.

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