A population-based cohort study found that mental health visits increased substantially among physicians during the beginning of the COVID-19 pandemic. These findings were published in JAMA Network Open.

Practicing physicians (N=34,055) in Ontario were assessed for in-person, telemedicine, and virtual care outpatient visits to a psychiatrist or family medicine and general practitioner using linked medical records through the Ontario Health Insurance Plan. Trends during the pandemic (March 2020-2021) were compared with those during prepandemic times (2017-2019).

The cohorts for 2019 (n=32,706) and 2020 (n=31,472) were comprised of physicians aged mean 42.2 (standard deviation [SD], 10.1) and 43.1 (SD, 10.1) years, 47.7% and 47.9% were women, and 17.4% and 18.3% had a mental health visit in the 2 years before COVID-19, respectively.

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The patterns of biweekly outpatient mental health and substance use visits followed similar seasonal patterns from 2017 until March 2020, at which time biweekly visits increased from 30.8 to 39.8 per 1000 physicians.

The proportion of all-cause outpatient visits by a physician for mental health or substance use was 23.0% prior to COVID-19 and 28.3% during the first 5 months of the pandemic, returning to prepandemic rates after the first wave.

During the pandemic, there was a 25.6% increase in the coding for mental health, with the greatest increase in anxiety and adjustment disorders. Conversely, visits related to social and economic issues and alcohol and substance use declined or remained stable.

Outpatient mental health and substance use-related visits by physicians during the first 12 months of the COVID-19 pandemic associated with mental health visit prior to the pandemic (adjusted incidence rate ratio [aIRR], 1.72; 95% CI, 1.60-1.85), female gender (aIRR, 1.16; 95% CI, 1.09-1.25), age <50 years (aIRR, 1.14; 95% CI, 1.07-1.21), not living in a rural area (aIRR, 1.13; 95% CI, 1.06-1.19), and not treating patients with COVID-19 (aIRR, 1.13; 95% CI, 1.06-1.21).

This study may be biased as physicians tend to have a low level of care-seeking behaviors overall.

The study authors concluded, “this study noted that, during the first 12 months of the COVID-19 pandemic, physicians in Ontario experienced an increase in outpatient visits related to mental health and substance use. These findings may signal that the mental health of physicians has been negatively affected by the pandemic. Future research should focus on longer term outcomes associated with the pandemic and explore associated risk and protective factors for physicians’ mental health to better target interventions.”

Disclosure: An author declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Myran DT, Cantor N, Rhodes E, et al. Physician health care visits for mental health and substance use during the COVID-19 pandemic in Ontario, Canada. JAMA Netw Open. 2022;5(1):e2143160. doi:10.1001/jamanetworkopen.2021.43160