Ontario postpartum mental health visits rise by 30% during COVID-19

postpartum mental health

Postpartum mental health visits for new mothers increased by 30% during the COVID-19 pandemic, as researchers suggest that the increased use of virtual appointments may have removed barriers to care

Research in the Canadian Medical Association Journal has revealed that particularly in the first 3 months after giving birth mental health visits for new mothers was higher during COVID-19.

Dr Simone Vigod, chief of psychiatry, senior scientist and interim vice president of academics at Women’s College Hospital (WCH), and senior adjunct scientist at ICES in Toronto, Ontario, with co-authors,  wrote: “Increased visit rates began in March 2020, although the state of emergency was declared only midway through the month, suggesting that distress related to the pandemic translated into an increased need for care very quickly.”

Postpartum mental illness impacts as many as 1 in 5 mothers and can have long-term effects on children and families if it becomes chronic.

A focus on Ontario

Researchers looked at mental health visits by 137,609 people in Ontario during the postpartum period (from date of birth to 365 days after) from March through November 2020 and collected data on age, number of children, neighbourhood income based on postal codes, neighbourhood ethnic diversity and region of residence based on the province’s 34 public health units.

They also divided the province into northern and southern public health units.

During the study period, mental health visits to both family physicians and psychiatrists were higher than before the pandemic, especially among parents with anxiety, depression, and alcohol and substance use disorders.

People living in northern public health units had relatively low increases after July 2020, perhaps because of fewer COVID-19 restrictions in those areas during the latter period.

The way care was delivered during the pandemic period differed from the period before – 84.8% of postpartum mental health visits were conducted virtually in April 2020 compared with only 3.1% of visits in the pre-pandemic period.

Removing barriers to postpartum mental health support

The authors suggest that enhanced use of virtual care may have removed barriers to postpartum mental health support, such as the need to travel, find childcare for older children, or manage erratic schedules, enabling more people to seek care.

Surprisingly, patients in the lowest income neighbourhoods had the smallest increase in mental health visits compared with people in other neighbourhoods.

“This raises some concern about the potential for unmet need because low-income patients may have greater barriers to accessing care, including difficulty affording the required technology or finding private space to attend virtual appointments (e.g., crowded homes), or less opportunity to attend “live” appointments because of employment in front-line jobs,” write the authors.

They recommend targeted approaches to providing mental health support.

“Health systems should focus proactively on patients from high-risk groups, monitor waiting lists for care, and explore creative solutions to expand system capacity, with special attention to postpartum patients who may be experiencing barriers to care,” researchers advised.

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